Neurocognition in childhood epilepsy: Impact on mortality and complete seizure remission 50 years later

SummaryObjectiveTo study associations of the severity of impairment in childhood neurocognition (NC) with long ‐term mortality and complete seizure remission.MethodsA population ‐based cohort of 245 subjects with childhood onset epilepsy was followed up for 50 years (median = 45, range = 2‐50). Childhood NC before age 18 years was assessed as a combination of formal intelligence quotient scores and functional criteria (school achievement, working history, and psychoneur ological development). Impaired NC was categorized with respect to definitions of intellectual functioning in International Classification of Diseases, 10th revision (R41.83, F70‐F73). The outcome variables, defined as all‐cause mortality and 10‐year terminal remission with the 5 past years of f medication (10YTR), were analyzed with Cox regression models.ResultsOf the 245 subjects, 119 (49%) had normal childhood NC, whereas 126 (51%) had various degrees of neurocognitive impairment. During the 50 ‐year observation period, 71 (29%) of the subjects died, 13% of those with normal and 44% of those with impaired NC. The hazard of death increased gradually in line with more impaired cognition, reaching significance in moderate, severe, and profound impairment versus normal NC (hazard ratio [Bonf erroni corrected 95% confidence interval] = 3.3 [1.2‐9.2], 4.2 [1.2‐14.2], and 5.5 [2.4‐12.3], respectively). The chance for 10YTR was highest among subjects with normal NC (61%), whereas none of those w...

Source: Epilepsia - November 22, 2018 Category: Neurology Authors: Matti Sillanp ää, Maiju M. Saarinen, Mira Karrasch, Dieter Schmidt, Bruce P. Hermann Tags: FULL ‐LENGTH ORIGINAL RESEARCH PAPER Source Type: research