Pediatric epilepsy and comorbid reading disorders, math disorders, or autism spectrum disorders: Impact of epilepsy on cognitive patterns

- Comorbidities are frequent in epilepsy in children.
- In isolated epilepsy, a verbal > nonverbal cognitive pattern is seen.
- Controls and other disorders do not display such VIQ > PIQ pattern.
- In comorbidities, patterns resemble partly the epilepsy and partly the other disorder.
- The “impact” of epilepsy on the cognitive pattern is similar across conditions.

IntroductionIn pediatric epilepsy, comorbidities are reported to be frequent. The present study focusedon the cognitive patterns of children with isolated epilepsy, children with isolated neurodevelopmental disorders (reading disorders, math disorders, autism spectrum disorders), and children with epilepsy and these neurodevelopmental disorders as comorbidities.MethodsBased on two samples of referred children, one with epilepsy, reading disorders, math disorders, or ASDs occurring in “isolation” (n = 117) and one with reading disorders, math disorders, and ASDs occurring comorbid with epilepsy (n = 171), cognitive patterns were compared. The patterns displayed by verbal and nonverbal abilities from the WISC series were studied with repeated measures ANOVA. Thereafter, an exploratory 2 ∗ 3 ∗ 2 factorial analysis was done to study the independent contribution of the type of comorbidity and of the presence or absence of epilepsy to the VIQ-PIQ pattern.ResultsIn isolated epilepsy, a VIQ > PIQ pattern was found, which was not seen in the other disorders. When epilepsy and another disorder co-occurred, patterns were altered. They resembled partly the pattern seen in isolated epilepsy and partly the pattern seen in the isolated neurodevelopmental disorder. In comorbid reading disorders, the VIQ > PIQ pattern was mitigated; in comorbid math disorders, it was exacerbated. In comorbid ASDs, no clear pattern emerged. In the presence of epilepsy, patterns characteristic of isolated disorders appeared systematically shifted toward relatively lowered performance abilities or relatively spared verbal abilities. The similar “impact” exerted by epilepsy on the patterns of the various conditions suggested shared mechanisms.