Understanding Epilepsy and Intellectual Disability in Adolescents through Clinical, Electrophysiological, and Neuroimaging Perspectives: A cross sectional study

A bstract Background: Epilepsy often co-occurs with intellectual disability (ID), presenting intricate clinical manifestations and treatment challenges. Understanding the interplay between epilepsy and ID is crucial for effective patient care and education. Materials and Methods: This study aimed to comprehensively investigate demographic, clinical, and neuroimaging and electrophysiological aspects of pediatric patients diagnosed with epilepsy, focusing on those with and without ID. Participants aged 14–19 years were enrolled. Results: A total of 133 adolescents were recruited (46 ID and 87 control). Individuals with ID had a longer duration of epilepsy and lower educational attainment. Seizure profiles exhibited variations, with a higher prevalence of generalized tonic–clonic seizures in the ID group (52.2% vs. 25.3%; P = 0.004). Treatment strategies differed as more participants with ID were prescribed specific antiepileptic drugs such as clobazam (69.6% vs. 25.3%; P < 0.001) and levetiracetam (71.7% vs. 41.4%; P = 0.001). Participants with ID experienced poorer seizure control (37% vs. 82.8%; P < 0.001) and had higher rates of refractory epilepsy (63% vs. 16.1%; P < 0.001). Individuals with ID displayed a lower prevalence of interictal epileptiform discharges (6.5% vs. 26.4%; P < 0.001) and higher generalized slowing (26.1% vs. 2.3%; P < 0.001) in EEG readings. Additionally, the ID group exhibited greater involvement of frontal and fronto-temporal brain areas, distinct seizure etiologies, and a higher prevalence of non-enhancing lesions (97.8% vs. 14.9%; P < 0.001). Discussion: The study’s findings emphasize the need for tailored approaches to patient care, considering the intricate interactions between epilepsy, cognitive impairments, and treatment strategies. Multidisciplinary collaboration is vital to address the multifaceted needs of patients with epilepsy and cognitive impairments.