Larry B. Silver, M.D.
If one area of the brain is wired differently, it is not uncommon
that other areas of the brain will be wired differently. The relationship
between epilepsy and learning disabilities is but one example.
Epilepsy, also called seizure disorders, is characterized by recurrent
seizures. It is associated with structural or biochemical brain
abnormalities. It is estimated that 1% of the general population
has epilepsy. This disorder occurs more commonly in boys than girls.
About 40% of individuals with epilepsy between the ages of 4 and
15 have one or more additional neurological disorders. The most
common ones are mental retardation, speech-language disabilities,
and specific learning disabilities. In fact, learning disabilities
are more prevalent in individuals with epilepsy (approaching 50%)
than in the general population.
One of the most notable effects of cognitive functioning in children
with epilepsy is memory impairment. This impairment can range from
poor concentration and minor forgetfulness to gross clouding of
consciousness and disorientation.
Epilepsy might impact on learning in other ways. Daytime seizures
can affect learning by reducing alertness and by interfering with
short-term information storage and abstraction. Frequent and uncontrolled
seizures impair learning new information due to the amount of time
that the individual is unaware of the environment. Night-time seizures
can disrupt the consolidation of memory and affect language functions.
Cognitive impairments can also be a side effect of the various
anticonvulsant medications used to treat epilepsy. Anticonvulsant
medications have been associated with learning difficulty, behavior
changes, and memory impairment. The drug most commonly implicated
with altered behavior is phenobarbital, which can cause hyperactivity
and memory impairment. Almost all anticonvulsant medications have
some adverse effects on cognition, learning, and mood. Additional
factors that are detrimental to learning include toxic levels of
anticonvulsant drugs and the use of more than one antiepileptic
medication. It is important when treating seizures in children with
learning difficulties to carefully assess the medication used and
the possible impact of this medication.
Larry B. Silver, MD, is a child psychiatrist in the Washington,
DC area and a past president of LDA. In answer to questions received
from readers, Dr. Silver very graciously agreed to summarize the
above information on the co-occurrence of epilepsy and learning
disabilities for the readers of Newsbriefs.
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