ABSTRACT
The aim of this study was to investigate the frequency of reading, writing, and calculation disabilities in children with typical rolandic epilepsy (RE) and healthy control children. We also aimed to define the possible electroclinical markers of specific cognitive dysfunctions in RE. School abilities were evaluated and compared in 20 children (eight males, 12 females; mean age 10y 3mo [SD 1y 7mo]; range 7y 9mo-12y 9mo) consecutively diagnosed with typical RE, and a group of 21 healthy controls (nine males, 12 females; mean age 10y 4mo [SD 1y 8mo]; range 7y 6mo-13y 3mo). All the children received standardized neuropsychological tests. For each patient an exhaustive seizure diary was kept and all the sleep electroencephalogram (EEG) recordings were reviewed. Specific difficulties with reading, writing, and calculation (diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition) were found in nine out of 20 children with RE and two out of 21 healthy controls (chi2=0.01). The specific learning disabilities in the RE group were correlated with a marked increase in epileptiform discharges during sleep (chi2=0.02) and an early onset of epilepsy (chi2=0.02). Our findings suggest that seizure onset before age 8 years and epileptiform discharges (more than 50% of the sleep EEG recording) in several tracings over more than a year are relevant markers for identifying patients at risk of developing academic difficulties.
Subject(s)
Achievement , Epilepsy, Rolandic/physiopathology , Mathematics , Reading , Writing , Adolescent , Chi-Square Distribution , Child , Electroencephalography , Female , Humans , Intelligence , Male , Neuropsychological TestsABSTRACT
The authors report the personality characteristics of 30 subjects, 16 males and 14 females, average age 13.7 years: 13 suffered from migraine without aura, 8 from migraine with aura and 9 from chronic tension-type headache. The study was based on a detailed clinical assessment (psychodynamically-oriented interviews with the child and its parents) and evaluation by tests. A blind test of the clinical personality characteristics was then carried out. The results of these investigations indicated that 13/30 of the subjects had a neurotic personality organization, 12/30 were borderline and 5/30 had a "white relation". Given the subjects' youth, these conditions are probably to be considered transient. From the data collected it seems that migrainous subjects are distributed along a continuum that ranges from one end characterized by more evolved and adaptive mental organization and defence mechanisms and the opposite end, where mental organization is less evolved and adaptive and at a greater risk of somatization.
