Cognition and Behavior in Childhood Epilepsy

Lagae L, ed. Cognition and Behavior in Childhood Epilepsy London, UK: Mac Keith Press; 2017 (186 pages). ISBN 978–1-909962–87–3.£50.00

The majority of children with epilepsy show intellectual performance within the normal range. However, patients with epilepsy do have a higher risk for behavioral and cognitive problems. This depends on a variety of factors, ranging from etiology, electroclinical syndrome, the course of the disease, age at onset, treatment modalities, etc., and ends with individual genetic predispositions and environmental factors. It is clear that behavior and cognition are strong determinants of quality of life and educational achievements, especially in children. However, it is a difficult task to study these aspects. One reason is that for many items of neuropsychological testing sensitivity and test–retest variability is within, or not far from the range of effect size of the item in the study. It is understood by the international community that published results on cognitive effects, for example, of anti epileptic drugs (AED) have to be interpreted with caution for flaws in experimental design, differing test batteries, etc. Nevertheless, in a significant number of children with epilepsy, cognitive, and behavioral issues may be just as important as seizure control. It is a common observation that parents of seizure-free children who are weaned from medication (e.g., valproic acid) spontaneously report that their children are more alert, livelier, and show improved academic performance. Therefore, it is pertinent for every clinician to acquire a profound knowledge on known determinants in this field of study.

The book is divided into 15 chapters covering many relevant aspects of cognition and behavior in childhood epileptology. I found myself reading the book with great pleasure and ended up with a highlighter in my hand to sample sources for future teaching sessions and personal reference. Every chapter concludes with a short conclusion (summary). In detail, the chapters cover the following topics:

1. Cognitive difficulties in children with epilepsy: Sources and implications

2. Introductory remarks on neuropsychological assessment of cognition in children with epilepsy

3. Behavioral problems in childhood epilepsy

4. The interaction between childhood-onset epilepsy and cognition with long-term follow-up

5. Functional imaging to study cognitive functions

6. Disentangling the role of seizures and EEG abnormalities in the pathophysiology of cognitive dysfunction

7. Chronic cognitive effects of antiepileptic drugs in childhood epilepsy

8. Outcome after neonatal seizures

9. “Benign” childhood epilepsy syndromes: why do some present with learning problems?

10. “Benign” infantile epilepsies: Impact on later cognition and behavior

11. Infantile spasms: early treatment may improve neurodevelopmental outcomes

12. Dravet syndrome: more than seizures

13. The epileptic syndromes with continuous spike and waves during slow-wave sleep

14. Global prognosis and neuropsychological outcome of Lennox–Gastaut syndrome

15. Cognitive and behavioral outcome after epilepsy surgery in children.

The authors of the individual chapters are internationally renowned experts in their field and give a comprehensive overview of known data together with an interpretive summary of findings that were corroborated by replication and may thus be accepted as proven concepts and results. The authors do not fail to emphasize where the limits of current knowledge are reached. Altogether this book is a concise, up to date, and easily readable companion for everybody trying to get acquainted with this important clinical field.