Abstract
Cognitive impairment is common in children and adolescents with epilepsy. Though there
is increasing recognition that even children with more benign epilepsy syndromes may
show cognitive loss over time, this is particularly true in children with severe epilepsies,
termed the epileptic encephalopathies. The current article discusses general cognition
in children with epilepsy, focusing on risk factors for cognitive decline over time
in severe epilepsies. The “epileptic encephalopathies” are briefly introduced and
methods for assessing cognitive loss over time are discussed with an emphasis on the
use of reliable change indices. The strengths and the limitations of this approach
are noted as they pertain to children. The article concludes with an illustrative
case example of a young child with a severe epilepsy syndrome and apparent cognitive
loss. The utility and limitations of reliable change indices are discussed within
the context of this case.
Keywords
epilepsy - children - epileptic encephalopathies - reliable change index
