Objective: Common neuropsychological sequelae of Seizure Disorder (SD) include problems with attention, executive functioning, memory, and processing speed. Sandifer's Syndrome (SS) is a rare pediatric gastrointestinal disorder resulting in spasms, emesis, and abnormal eye movements; as such, these episodes are often misdiagnosed as seizures. Previous SD studies utilized outdated, less comprehensive neuropsychological measures, while there are no neuropsychological studies regarding SS. Neuropsychological functioning of an 8 year-old female with history of seizures and possible SS is presented. Findings will contribute to the limited literature regarding cognitive functioning secondary to pediatric SD and possible SS using updated, comprehensive neuropsychological assessments. Method: Patient's history includes one generalized tonic-clonic seizure (age 3), one partial-complex seizure (age 4), and numerous absence seizures. Episodes involved emesis, choking, and left-eye deviation consistent with SS and SD. EEG results indicated abnormality in the right frontal lobe, suggesting presence of both SD and SS. Comprehensive neuropsychological testing at age 8 included WISC-V, WJ-IV, D-KEFS, NEPSY-2, WRAML-2, TEA-Ch, SCAN-C, CATA, Grip Strength/Grooved Pegs, Beery VMI, Category Test, and behavioral/emotional measures. Results: Neuropsychological testing revealed primarily average functioning in intellectual, perceptual/spatial, language, fine-motor, and academic abilities. Relative weaknesses were noted in auditory processing; processing speed; effortful/passive/divided attention; verbal/visual/associative memory; and nonverbal/verbal executive functioning. Conclusion: Due to similarities between SD and SS, medical follow-up to avoid misdiagnosis is warranted. Appropriate diagnosis of SS has good prognosis with treatment and avoids unnecessary therapies using anticonvulsant medications. Updated measures in comprehensive neuropsychological testing will help delineate cognitive functioning of pediatric SD and possible SS and recommend appropriate interventions.
Comprehensive Neuropsychological Testing in a Child with Seizures and Possible Sandifer's Syndrome: A Case Study
J Garcia, A Dreher, L Hernandez, K Leon, K Marquez, T Alves, S Tanner-Woodward; C-08
Comprehensive Neuropsychological Testing in a Child with Seizures and Possible Sandifer's Syndrome: A Case Study. Arch Clin Neuropsychol 2016; 31 (6): 643. doi: 10.1093/arclin/acw043.157
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