As with any medical condition, there are numerous comorbidities associated with epilepsy.
Intellectual Disability and Learning Disorders
Approximately 25% of children with epilepsy have comorbid intellectual disability and nearly half have other learning disorders. Even in the so-called benign childhood epilepsy syndromes, it is common for there to be learning or behavioral impairment. Cognitive problems may be the direct result of the underlying etiology for the epilepsy, and thus do not significantly improve even if seizure control is achieved (developmental encephalopathy). Conversely, in other cases the degree of intellectual disability correlates strongly with severity of epilepsy and improves with better seizure control (epileptic encephalopathy).
Children with epilepsy should be screened for cognitive delays before school entry, or if epilepsy onset is later, at the time of diagnosis, and then periodically thereafter. If delays are present the pediatrician should inform parents of their right to request their child be evaluated for an individualized education plan (IEP) or a 504 plan (Fig 4). Both plans can cover modifications or accommodations to the classroom or educational materials, but an IEP would cover individualized special education services, whereas a 504 plan is more broadly aimed at providing the child with access to the proper learning environment.