Frequency of epilepsy and pathological EEG findings in a Norwegian sample of children with fetal alcohol spectrum disorder: Impact on cognition and adaptive functioning.

BACKGROUND: Fetal alcohol spectrum disorder (FASD) describes a combination of developmental, cognitive and behavioural disabilities that that occur in children exposed to prenatal alcohol. Higher prevalence of epilepsy and pathological electroencephalography (EEG) have been reported. Our study aimed to examine the frequency of epilepsy, pathological EEG findings and its possible implication on cognitive and adaptive functioning.

METHODS: We conducted a cross-sectional study on 148 children with FASD. Participants underwent a multidisciplinary assessment and a 120-minute EEG recording. Group comparisons and regression analyses were performed to test the associations between epilepsy and pathological EEG findings in FASD subgroups and neurocognitive test results and adaptive functioning.

RESULTS: The frequency of epilepsy was 6% compared to 0.7% in Norway overall. Pathological EEG was found in 17% of children without epilepsy. Attention-deficit hyperactivity disorder (ADHD) comorbidity was diagnosed in 64% of the children. Children with epilepsy and/or pathological EEG findings did not have lower cognitive and adaptive scores compared with those with normal EEG. However, children with frontal EEG-pathology (but without epilepsy) had significantly lower scores on the IQ indices Processing speed and Working memory compared to FASD children without such findings, irrespective of ADHD comorbidity.

CONCLUSIONS: There was an increased frequency of epilepsy among children with FASD. An increased frequency of EEG pathology was found in children without epilepsy, across all FASD subgroups. Irrespective of epilepsy, ADHD comorbidity and FASD subgroup, children with frontal EEG pathology had normal total IQ, but significantly reduced processing speed and working memory, which may indicate specific executive function deficits that may affect learning and adaptive functioning.