3. Epileptic syndromes and types of epilepsy.

Idiopathic Generalized Seizures
Generally, individuals who have idiopathic generalized epilepsies (e.g. benign neonatal, simple febrile, childhood/juvenile absence, juvenile myoclonic, and idiopathic grand mal) and benign partial epilepsies of childhood, are intellectually average. However, recent studies suggest that some people with these conditions may show ‘subtle’ disturbances of learning functions that can cause challenges at school and affect attention.

Generalized seizures can, but do not always, affect memory, mental speed and flexibility, planning and organization, language, concentration, abstract reasoning, decision-making, inhibition, perceptual abilities, and anticipation. Because generalized seizures affect the entire brain, any cognitive ability could be subtly affected by them. Those with generalized seizures tend to have more learning difficulties than do those with partial (focal) seizures. Generalized tonic-clonic or grand mal seizures are associated with more difficulty than generalized absence seizures.

Specific Epileptic Syndromes
Conditions such as Infantile Spasms, Lennox-Gastaut Syndrome, most of the myoclonic epilepsies, epilepsy with continuous spike-waves during slow sleep, Landau-Kleffner syndrome are often (but not always) associated with significant impairment of learning and behaviour. Once again, those whose conditions are “idiopathic” are less likely to have learning difficulties than those who have a symptomatic basis of their epilepsy.


4. Seizure frequency, severity, and duration

For each individual the effect a seizure has on their academic abilities and brain functions will be different. Two individuals of the same age, sex, on the same medication, with the same seizure type, frequency, and severity may react differently to seizures. Thus, one person may develop difficulties learning and retaining information while the other remains at average or above-average levels of academic achievement.

Some children with poorly controlled seizures may show a decline in IQ; however, this decline is not necessarily permanent. If seizures continue to be severe, over time academic achievement will remain slightly lower. However, if seizure severity or frequency decreases, level of achievement may, and in many cases does, increase. Teachers must realize that even if there is improvement in seizure control and the child seems able to function well academically, that child may have to re-learn much of the material already covered in order to make up for the learning that was disrupted by the seizures.

Many studies show that people with inactive or low-severity epilepsy are average or above-average in reading, mathematical, and language abilities. Only in high-severity cases do differences in these abilities become apparent.