The Mystery of the Falling Grades: Seizure Disorder

Abstract

Working with children with epilepsy is like reading a good mystery. When learning or emotional problems occur, the neuropsychologist 's job is to help identify “whodunit.” The list of likely suspects from the epilepsy perspective include whatever is atypical about the brain that is the basis of the seizures, seizures themselves, abnormal electrical discharges between seizures (also known as sub-clinical seizures), and side effects of medications used to treat the seizures. These suspects may set the stage for problems with attention, learning, memory, and emotional functioning. The reactions of family and friends to the epilepsy diagnosis and/or seizures may lead to feelings of anxiety and depression. Children with epilepsy can also develop learning or emotional problems for the same reasons that other children do, such as genetics or life experiences. John was referred for neuropsychological evaluation to sort through these suspects to find the cause of his falling grades.

John was attending seventh grade at the time of referral. His parents reported that he started off well in school. He began reading prior to starting kindergarten. He was placed in a program for gifted students in first grade and continued in this program throughout elementary school. John developed complex partial seizures between fourth and fifth grade. John would become confused during seizures and was sleepy after a seizure ended. Since seizures were only occurring at home, his parents informed the school nurse, but no one else knew about his epilepsy. His antiepileptic drug (AED) supported good seizure control. During fifth grade, John seemed to work harder for his grades but continued to do well.