Neurobiological and psychosocial influences on the neuropsychological functioning of children with epilepsy

Abstract

The aim of the study was to investigate the neurobiological and psychosocial factors that influence neuropsychological test performance in children with epilepsy from a non-Western rural background. The sample comprised 100 children with tonic-clonic seizures and 100 children with simple partial seizures between the ages of eight to twelve years. A third group of 100 children with chronic renal problems was used as a comparison to control for the effects of having a chronic illness. The findings of the present study indicate that in the epilepsy groups, seizure variables such as the age of onset, frequency of seizures and duration of seizures have an impact on self-esteem, adjustment and NEPSY scores. However, psychosocial and emotional factors appear to have a greater impact than neurobiological variables on the measured neuropsychological domains (attention/executive, language, sensorymotor and learning/memory functions). These findings are consistent with the theoretical perspectives used, combining the view of Piaget (1955) that cognitive development proceeds as a result of the child’s own activities, with Luria’s (1973) model of brain functioning and the stance of Vygotsky (1978) that development is a socially mediated process. The findings regarding the influence of neurobiological and psychosocial factors on neuropsychological test performance in children with epilepsy from non-Western backgrounds are similar to those of Western studies. Epilepsy presents with unique problems relative to other chronic illnesses. The three groups are separated according to differences in psychosocial (maternal attitudes), emotional (adjustment and self-esteem) as well as neuropsychological functioning (attention/executive, language and visual-spatial skills). The renal group is characterised by the highest levels of psychosocial, emotional and neuropsychological functioning, while the simple partial seizure group have lower levels of psychosocial and emotional functioning, and the tonic-clonic seizure group have the lowest levels of neuropsychological functioning and adjustment.