Authors: María de los Ángeles Villarreal¹, Ana Carrasco², María Beatriz Amado³ and Mario Pimentel⁴

⚡️ Introduction: The Electrical Brain

The brain is made up of cells called neurons that communicate with each other through synapses, structures that allow the transmission of information from one cell to another (Institute of Applied Neurosciences, 2022). This process involves chemical signals, but also electrical ones ⚡️. Alterations in brain electrical conduction are characteristic of epileptic activity.

In this article, we will delve into what epilepsy is, the factors associated with the diagnosis that could impact the academic performance of school-aged children, and the importance of neuropsychology during the evaluation and treatment process within the international and Panamanian contexts. Finally, we will analyze how a transdisciplinary team can help comprehensively address the needs of this population group.

🔎 What is epilepsy and what are its types?

Epilepsy is defined, according to Ardila and Rosselli (2019), as the neurological condition where sudden, intense and often brief electrical changes occur in neuronal activity; in conjunction with the presence of convulsive phenomena.

The common factor in epilepsies is called a seizure , which is the transient appearance of signs or symptoms due to excessive neuronal activity. The type of seizure varies depending on the involvement of the cerebral cortex:

  • Focal seizures: These are located within a specific area of the cortex. Consciousness may be preserved or impaired. Affected areas may include motor, sensory, cognitive, and emotional skills.

  • Generalized seizures: They are located throughout the cortex and originate at some point in the neural networks.

Clinical note: Seizures that occur sequentially over a long period can cause neuronal damage or death and alterations in neuronal networks, depending on the type and duration of the seizures (Onandia-Hinchado and Del Olmo, 2023).

🧐 Neuropsychological Implications in the Educational Field

When we talk about epilepsy, we are referring to a complex condition with effects on neurodevelopment, cognition, behavior, and academic performance. The cognitive profile can range from average performance to global dysfunction. Several factors influence the educational setting:

1. Aspects associated with crises 📉

Early onset and high frequency of seizures may be associated with neuropsychological alterations and decreased performance in attentional, reading and writing tasks and arithmetic.

2. Pharmacological treatment 💊

The physiological effect of drugs can have side effects on:

  • Attention and Memory

  • Executive Functioning

  • Perceptual alterations

According to Campos-Castelló and Campos-Soler (2004), patients with epilepsy are three times more likely to have difficulties in their cognitive performance compared to people without alteration in their brain activity.

3. Sleep disturbances 💤

They frequently cause or intensify cognitive, emotional, and behavioral difficulties.

4. Frequent comorbidities 🔗

It is vital to consider that a diagnosis of epilepsy can coexist with:

  • ADHD (Attention Deficit Hyperactivity Disorder)

  • Learning and language difficulties

  • Autism Spectrum Disorder (ASD)

  • Emotional and anxiety problems

🧠 Emotional Health and Social Stigma

Prolonged diagnosis and treatment can generate high levels of stress. Erroneous beliefs about the disease can lead to isolation and exclusion, which are related to symptoms of anxiety and depression (Díaz Garcés et al, 2022).

How can emotional difficulties be prevented? Self-efficacy (belief in one's own abilities) is a key factor. Fostering self-efficacy helps reduce emotional symptoms and improve quality of life. Furthermore, the use of psychoeducational tools for parents and patients is essential to strengthen the management of the diagnosis.

🥼 Medical and Surgical Treatment

As a medical condition, epilepsy involves antiepileptic drugs. However, in cases of drug-resistant epilepsy , surgery is a primary course of action, especially in children, providing benefits in seizure control and cognitive development (Madaan, Gupta, and Gulati, 2021).

🇵🇦 The Context in Panama

In Panama, 35,000 people have been diagnosed with epilepsy.

📊 Neuropsychological Assessment: Key Tests

The goals of neuropsychological assessment are to obtain an appropriate diagnosis to inform better treatment decisions. Some tests used at Neuropsyedu include:

  • ✅ WPPSI-IV, WISC-V and WAIS-IV: Intelligence scales (reasoning, working memory, speed).

  • ✅ NEPSY-II: Global assessment (attention, language, executive functions, perception).

  • ✅ TOMAL: Memory and Learning Test (verbal and non-verbal).

  • ✅ ENFEN: Neuropsychological Evaluation of Executive Functions.

  • ✅ Five Digit Test: Processing speed and inhibition (Stroop effect).

  • ✅ DTVP-3 Frostig: Visual perception and visuomotor integration.

  • ✅ d2-R Test: Selective attention and concentration.

🔄 Intervention and Neurorehabilitation

Each patient's pattern varies. An effective neurorehabilitation program should consider:

  1. Age of onset: Early onset (0-5 years) carries a higher risk.

  2. Type of crisis: Generalized vs. Focal.

  3. Frequency and Etiology.

  4. Pharmacology.

In drug-resistant cases, neuropsychological intervention is vital to compensate for alterations in attention, memory, and executive functions through adjustments in the environment and direct training.

Contact for Evaluation

🤩 If you're interested in a neuropsychological evaluation, remember that the Comprehensive Center for Educational Neuropsychology is your partner for these services. For more information, you can contact us at +507 6535 6362 , and we'll be happy to assist you.