Alteraciones neuropsicológicas en pacientes con Epilepsia de Ausencia Infantil. Estudio descriptivo transversal
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Fecha
2025
Autores
Sánchez Aguilar, Verena
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Ediciones Universidad Simón Bolívar
Facultad Ciencias de la Salud
Facultad Ciencias de la Salud
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Introducción: La epilepsia tipo crisis de ausencia (CA) es una condición neurológica que afecta a niños en edades tempranas, caracterizada por episodios breves de desconexión del entorno. Esta patología puede estar asociada a alteraciones en el desarrollo motor, lingüístico y cognitivo. El estudio se propone analizar el perfil neuropsicológico de niños con CA, explorando la relación entre variables del desarrollo, edad de inicio de las crisis y el rendimiento en pruebas cognitivas, así como comparar los hallazgos con evidencia científica previa. Métodos: Se utilizó un diseño observacional descriptivo con análisis estadístico de distribución, correlación y comparación de medias. La muestra incluyó 14 niños diagnosticados con CA, divididos en tres grupos etarios: 6-8, 9-10 y 11-13 años. Se aplicaron instrumentos neuropsicológicos como el Trail Making Test A y B, la prueba de la Figura de Rey, escalas de Comprensión Verbal, Memoria de Trabajo, Velocidad de Procesamiento y Coeficiente Intelectual Total (CI). También se evaluaron variables del desarrollo como edad de marcha, primeras palabras, frases y edad de escolarización. Resultados: El análisis de la edad de inicio de la conciencia fonológica mostró mayor variabilidad en los niños más pequeños (6-8 años) y mayor homogeneidad en los mayores (11-13 años), aunque con una mediana constante de 7 años en todos los grupos. Se identificó una distribución no normal en variables del desarrollo motor y del lenguaje (p < 0.05), lo que refleja diferencias individuales importantes. A nivel cognitivo, los niños de 9-10 años tuvieron mejores resultados en tareas de atención y flexibilidad cognitiva, mientras que los más pequeños destacaron en CI Total y Comprensión Verbal. El CI Total mostró correlaciones significativas con múltiples funciones cognitivas, y la edad de inicio de las crisis se relacionó positivamente con mejor desempeño en razonamiento perceptivo y memoria de trabajo. Además, se evidenció una relación negativa entre errores perseverativos y desempeño en tareas de categorización. Conclusiones: Los resultados indican que la edad de inicio de la conciencia fonológica se mantiene constante en torno a los 7 años, pero con mayor variabilidad en los grupos más jóvenes. Las diferencias en el desarrollo motor y lingüístico sugieren una heterogeneidad marcada en niños con CA. En términos cognitivos, ciertas habilidades alcanzan su punto máximo en la infancia intermedia, mientras que otras se mantienen estables. Las correlaciones halladas entre edad de inicio de las crisis y desempeño cognitivo destacan la importancia de una detección temprana y de intervenciones neuropsicológicas específicas. El estudio refuerza la necesidad de evaluar de forma integral el desarrollo en esta población, en concordancia con la evidencia científica existente.
Childhood absence epilepsy (CAE) is one of the most common generalized epileptic syndromes in children. It typically manifests with frequent, brief episodes of impaired consciousness and is often associated with alterations in neurodevelopment. The age of onset, developmental milestones, and neuropsychological performance are critical indicators for understanding the cognitive profiles of children with CAE and guiding timely clinical interventions. This study aimed to explore the relationship between the onset age of absence seizures and various neurodevelopmental and neuropsychological variables, with an emphasis on cognitive performance, language acquisition, and motor milestones. Methods: A descriptive, cross-sectional study was conducted with a sample of 14 children diagnosed with CAE, aged between 6 and 13 years, equally distributed by gender. Sociodemographic, motor, language, and educational development data were collected. Neuropsychological assessment included tests such as the Trail Making Test (TMT A and B), Wechsler Intelligence Scale for Children (WISC), Wisconsin Card Sorting Test (WCST), and Rey-Osterrieth Complex Figure Test. Statistical analyses included boxplots, descriptive statistics, and Pearson correlations to identify relationships between variables and the age of seizure onset. Results: The boxplot analysis of seizure onset by age groups (6–8, 9–10, and 11–13 years) revealed greater variability in younger groups, with a consistent median onset around 7 years across all groups. Non-normally distributed variables (e.g., walking age, first words, school entry age) indicated greater variability in motor and language development. Neuropsychological test results showed higher mean scores in Perceptual Reasoning (M = 94.57), Verbal Comprehension (M = 84.93), and Full-Scale IQ (M = 83.14), while WCST Categories (M = 3.57) had the lowest mean. Group comparisons by age showed that children aged 9–10 years had the best performance in cognitive flexibility (TMT-B) and attention (TMT-A), while younger children performed better on general intelligence measures. Verbal comprehension slightly declined with age, possibly related to frequent epileptic episodes. The correlation matrix indicated significant associations between seizure onset age and cognitive variables: later onset correlated positively with better scores in Perceptual Reasoning (r = 0.607, p < 0.05) and Working Memory (r = 0.613, p < 0.05). Working Memory was also strongly related to Rey figure recall (r = 0.716) and Perceptual Reasoning (r = 0.707). Verbal Comprehension strongly correlated with Full- Scale IQ (r = 0.835), underscoring its relevance to overall cognitive function. Perseverative errors on the WCST showed a negative correlation with the number of categories completed (r = -0.627), indicating impaired executive functioning. Conclusions: The findings suggest a relatively stable age of onset for CAE, around 7 years, with greater developmental variability in younger children. Cognitive functioning is heterogeneously affected, with specific strengths in perceptual reasoning and weaknesses in executive functioning and verbal comprehension, particularly in older age groups. Correlations indicate that later seizure onset may be associated with better cognitive outcomes. These results highlight the importance of early detection and neuropsychological assessment to tailor interventions that support cognitive development in children with CAE.
Childhood absence epilepsy (CAE) is one of the most common generalized epileptic syndromes in children. It typically manifests with frequent, brief episodes of impaired consciousness and is often associated with alterations in neurodevelopment. The age of onset, developmental milestones, and neuropsychological performance are critical indicators for understanding the cognitive profiles of children with CAE and guiding timely clinical interventions. This study aimed to explore the relationship between the onset age of absence seizures and various neurodevelopmental and neuropsychological variables, with an emphasis on cognitive performance, language acquisition, and motor milestones. Methods: A descriptive, cross-sectional study was conducted with a sample of 14 children diagnosed with CAE, aged between 6 and 13 years, equally distributed by gender. Sociodemographic, motor, language, and educational development data were collected. Neuropsychological assessment included tests such as the Trail Making Test (TMT A and B), Wechsler Intelligence Scale for Children (WISC), Wisconsin Card Sorting Test (WCST), and Rey-Osterrieth Complex Figure Test. Statistical analyses included boxplots, descriptive statistics, and Pearson correlations to identify relationships between variables and the age of seizure onset. Results: The boxplot analysis of seizure onset by age groups (6–8, 9–10, and 11–13 years) revealed greater variability in younger groups, with a consistent median onset around 7 years across all groups. Non-normally distributed variables (e.g., walking age, first words, school entry age) indicated greater variability in motor and language development. Neuropsychological test results showed higher mean scores in Perceptual Reasoning (M = 94.57), Verbal Comprehension (M = 84.93), and Full-Scale IQ (M = 83.14), while WCST Categories (M = 3.57) had the lowest mean. Group comparisons by age showed that children aged 9–10 years had the best performance in cognitive flexibility (TMT-B) and attention (TMT-A), while younger children performed better on general intelligence measures. Verbal comprehension slightly declined with age, possibly related to frequent epileptic episodes. The correlation matrix indicated significant associations between seizure onset age and cognitive variables: later onset correlated positively with better scores in Perceptual Reasoning (r = 0.607, p < 0.05) and Working Memory (r = 0.613, p < 0.05). Working Memory was also strongly related to Rey figure recall (r = 0.716) and Perceptual Reasoning (r = 0.707). Verbal Comprehension strongly correlated with Full- Scale IQ (r = 0.835), underscoring its relevance to overall cognitive function. Perseverative errors on the WCST showed a negative correlation with the number of categories completed (r = -0.627), indicating impaired executive functioning. Conclusions: The findings suggest a relatively stable age of onset for CAE, around 7 years, with greater developmental variability in younger children. Cognitive functioning is heterogeneously affected, with specific strengths in perceptual reasoning and weaknesses in executive functioning and verbal comprehension, particularly in older age groups. Correlations indicate that later seizure onset may be associated with better cognitive outcomes. These results highlight the importance of early detection and neuropsychological assessment to tailor interventions that support cognitive development in children with CAE.
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Epilepsia tipo crisis de ausencia, Desarrollo cognitivo, Neuropsicología infantil, Memoria de trabajo, Coeficiente intelectual, Funciones ejecutivas, Conciencia fonológica, Desarrollo motor y lingüístico