INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #13 Neurodevelopmental Profile of a Pediatric Patient with Catamenial Epilepsy Demy Alfonso, Emory/Children's Healthcare of Atlanta, Atlanta, United States Adriana Mendez, Emory/Children's Healthcare of Atlanta, Atlanta, United States Eva del Valle Martinez, Emory/Children's Healthcare of Atlanta, Atlanta, United States Donald Bearden, Emory/Children's Healthcare of Atlanta, Atlanta, United States Category: Epilepsy/Seizures Keyword 1: epilepsy / seizure disorders Keyword 2: pediatric neuropsychology Keyword 3: medical disorders/illness Objective: Catamenial epilepsy describes seizures associated with the menstrual cycle. Patients may experience worsening of seizures during the perimenstrual, pre-ovulation, and ovulation phases of their menstrual cycle. A published study¹ on the neuropsychological profile associated with catamenial epilepsy described cognitive impairment in almost 60% of cases and included specific impairment in short-term memory. However, this was an adult study (mean age = 38) in Uzbekistan. While studies have shown neurological features associated with pediatric epilepsy typically include problems with attention, learning and memory, academic achievement, and psychiatric symptoms, no studies were found related to neuropsychological correlates of catamenial epilepsy within pediatric populations at the time of abstract submission. Our case study presents data from a 16-year-old female patient who presented with catamenial epilepsy. Participants and Methods: The patient was a 16-year-old, right-handed female with a history of catamenial epilepsy beginning at age 13 with seizures predominantly occurring in the perimenstrual phase of her cycle. At the time of evaluation, seizure frequency had increased while duration had decreased. Use of estrogen-progestin oral contraceptives was attempted to manage hormonal changes with seizures but did not improve seizure control. Seizures were treated with antiseizure medications (ASMs) including clonazepam, levetiracetam, lamotrigine, and zonisamide. Medical and family history were otherwise unremarkable. There was no history of academic concerns. Results: Neuropsychological evaluation results indicated average overall intellectual ability with significantly stronger verbal comprehension (50%ile) than perceptual reasoning (14%ile). Attention and executive function skills were variable; she struggled with auditory attention (16%ile), working memory (18%ile), and nonverbal fluency (9%ile). Processing speed and efficiency were below average (5%ile). Fine-motor coordination weaknesses were evident (3%ile and below). Further, patient’s adaptive skills were below expectation and seemed to be impacted by slow processing, inattention, and executive dysfunction. Based on this information, a 504 Plan was recommended at school with accommodations for inattentiveness, distractibility, multi-step instructions, planning and organization, problem-solving, encoding and consolidation of information, monitoring of performance, and additional time on tasks and exams. Additional recommendations include psychotherapy, occupational therapy, and adaptive skill development. Conclusions: Limited published studies exist examining neuropsychological profiles in catamenial epilepsy. This is especially important in pediatric populations where neuropsychological development is ongoing. Our case study is one of the first to provide information on the neurocognitive profile of a pediatric patient with catamenial epilepsy, but more information and research is necessary. Examining cognitive profiles in patients with catamenial epilepsy before and during hormonal treatment may also be informative. Rakhimbaeva GS. NEUROPSYCHOLOGICAL ASPECTS OF CATAMENIAL EPILEPSY. Central Asian Journal of Medicine. 2018;2018(3):130-40.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #13

Neurodevelopmental Profile of a Pediatric Patient with Catamenial Epilepsy

Demy Alfonso, Emory/Children's Healthcare of Atlanta, Atlanta, United States
Adriana Mendez, Emory/Children's Healthcare of Atlanta, Atlanta, United States
Eva del Valle Martinez, Emory/Children's Healthcare of Atlanta, Atlanta, United States
Donald Bearden, Emory/Children's Healthcare of Atlanta, Atlanta, United States

Category: Epilepsy/Seizures

Keyword 1: epilepsy / seizure disorders
Keyword 2: pediatric neuropsychology
Keyword 3: medical disorders/illness

Objective:

Catamenial epilepsy describes seizures associated with the menstrual cycle. Patients may experience worsening of seizures during the perimenstrual, pre-ovulation, and ovulation phases of their menstrual cycle. A published study¹ on the neuropsychological profile associated with catamenial epilepsy described cognitive impairment in almost 60% of cases and included specific impairment in short-term memory. However, this was an adult study (mean age = 38) in Uzbekistan. While studies have shown neurological features associated with pediatric epilepsy typically include problems with attention, learning and memory, academic achievement, and psychiatric symptoms, no studies were found related to neuropsychological correlates of catamenial epilepsy within pediatric populations at the time of abstract submission. Our case study presents data from a 16-year-old female patient who presented with catamenial epilepsy.

Participants and Methods:

The patient was a 16-year-old, right-handed female with a history of catamenial epilepsy beginning at age 13 with seizures predominantly occurring in the perimenstrual phase of her cycle. At the time of evaluation, seizure frequency had increased while duration had decreased. Use of estrogen-progestin oral contraceptives was attempted to manage hormonal changes with seizures but did not improve seizure control. Seizures were treated with antiseizure medications (ASMs) including clonazepam, levetiracetam, lamotrigine, and zonisamide. Medical and family history were otherwise unremarkable. There was no history of academic concerns.

Results:

Neuropsychological evaluation results indicated average overall intellectual ability with significantly stronger verbal comprehension (50%ile) than perceptual reasoning (14%ile). Attention and executive function skills were variable; she struggled with auditory attention (16%ile), working memory (18%ile), and nonverbal fluency (9%ile). Processing speed and efficiency were below average (5%ile). Fine-motor coordination weaknesses were evident (3%ile and below). Further, patient’s adaptive skills were below expectation and seemed to be impacted by slow processing, inattention, and executive dysfunction. Based on this information, a 504 Plan was recommended at school with accommodations for inattentiveness, distractibility, multi-step instructions, planning and organization, problem-solving, encoding and consolidation of information, monitoring of performance, and additional time on tasks and exams. Additional recommendations include psychotherapy, occupational therapy, and adaptive skill development.

Conclusions:

Limited published studies exist examining neuropsychological profiles in catamenial epilepsy. This is especially important in pediatric populations where neuropsychological development is ongoing. Our case study is one of the first to provide information on the neurocognitive profile of a pediatric patient with catamenial epilepsy, but more information and research is necessary. Examining cognitive profiles in patients with catamenial epilepsy before and during hormonal treatment may also be informative.

Rakhimbaeva GS. NEUROPSYCHOLOGICAL ASPECTS OF CATAMENIAL EPILEPSY. Central Asian Journal of Medicine. 2018;2018(3):130-40.