A Systematic Review of Cognitive Challenges in Children with Focal Epilepsy

Abstract

Epilepsy is a chronic neurological disorder characterized by recurrent seizures, which can significantly impact cognitive development, particularly in children. Among pediatric cases, focal epilepsy, including Frontal Lobe Epilepsy (FLE) and Temporal Lobe Epilepsy (TLE), is associated with substantial cognitive deficits, such as impairments in memory, executive functions, and overall cognitive development. To ensure a thorough examination, we conducted a systematic review using the Embase and Medline databases, focusing on studies from the last decade that explore cognitive outcomes in children aged 0-18 years diagnosed with focal epilepsy. We used keywords like "focal epilepsy," "frontal lobe epilepsy," "temporal lobe epilepsy," "cognition," and "memory" to guide our search. The review identified significant memory impairments, especially in verbal memory recall and the memorization of verbal and visual materials, which are particularly seen in children with TLE. Additionally, children with FLE exhibited executive function deficits, including issues with mental flexibility, attention, working memory, and inhibitory control. These cognitive challenges are further seen in cases of multilobar epilepsy and early-onset epilepsy, where disruptions during critical periods of brain development may result in more cognitive impairments. This review also highlights some important gaps in current research, including a need for long-term studies on cognitive outcomes and a better understanding of how factors like medication and other health conditions might influence these outcomes. Furthermore, future research should focus on how cognitive functions develop over time in children with epilepsy, the long-term effects of antiepileptic drugs, and the role of genetic and environmental factors. Addressing these issues is key to improving clinical strategies, educational support, and improving the quality of life for children with focal epilepsy.