Impact of Spike Frequency and Location on Cognitive and Emotional Development in Children with Genetic Generalized and Self-Limited Epilepsy

Abstract Objective Genetic generalized epilepsy (GGE) and self-limited focal epilepsy (SeLFE) are associated with normal intelligence, but evidence shows patients may face increased cognitive and emotional difficulties compared with the general population. This study aimed to investigate the impact of inter-ictal discharges (IEDs) on cognitive and emotional functioning in children with epilepsy. Methods Participants included 113 children (57.5% female), aged 8 to 18, who completed the NIH Toolbox cognitive battery assessing executive function, attention, episodic memory, language, and processing speed. They also completed the Children's Depression Inventory 2nd Edition (CDI-2) and the Multidimensional Anxiety Scale for Children 2nd Edition (MASC-2). IED frequency and location/laterality were documented. Results One hundred and thirteen patients were included in the analysis. Cognitive scores fell within the Low Average to Average range, and MASC-2 and CDI-2 scores also fell within the Average range overall. No significant associations were observed between IED frequency or laterality and cognitive performance (p > .05). Likewise, IED frequency and laterality showed no significant effects on total CDI-2 or MASC-2 scores (p > .05). Conclusions Routine EEG IED frequency and laterality appear to have limited effects on cognition, depression, and anxiety in children with GGE and SeLFE, which may help guide family counseling regarding routine EEG findings.