NEUROCOGNITIVE OUTCOMES ASSOCIATED WITH EARLY-ONSET EPILEPSY IN PEDIATRIC PATIENTS: A SYSTEMATIC REVIEW

Resumo

Early-onset epilepsy is a prevalent neurological disorder in childhood and may negatively affect neurocognitive development during critical periods of brain maturation. Factors such as age at seizure onset, epilepsy etiology, seizure burden, and antiseizure medication use may contribute to cognitive impairment. This systematic review aimed to analyze the available evidence on neurocognitive outcomes associated with early-onset epilepsy in pediatric patients and explore potential underlying mechanisms. A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. PubMed was searched using descriptors related to epilepsy, children, neurocognitive disorders, child development, and cognition. Studies published within the last 15 years in English or Portuguese were considered, and 10 studies were included in the qualitative synthesis. Methodological quality was assessed using the SANRA and EPHPP tools. Early-onset epilepsy was consistently associated with impairments in executive function, attention, memory, language, visuomotor skills, and psychomotor processing speed. Poorer outcomes were associated with earlier seizure onset, refractory epilepsy, epileptic encephalopathies, and structural or genetic etiologies. Early-onset epilepsy is strongly associated with persistent neurocognitive impairment, highlighting the importance of early assessment, multidisciplinary follow-up, and individualized interventions to optimize developmental outcomes.