Development of intelligence and memory in children with hemiplegic cerebral palsy. The deleterious consequences of early seizures.

Although substantial data exist regarding the consequences of early lateralized cerebral lesions on intelligence and language ability, little is known about the development of other cognitive functions after such lesions. We examined the development of both verbal and nonverbal memory in 82 hemiplegic children, grouped according to hemispheric side of injury and presence or absence of seizure disorder. The control group consisted of 41 age-matched normal children, most of them siblings of the patients. Measures were obtained of intelligence and of immediate and delayed recall for prose passages, word paired associates and geometric designs. Electrophysiological and neuroradiological measures were available for a majority of the patients. The scores of the hemiplegic children on the IQ and memory tests did not exhibit the pattern seen in brain-damaged adults, in that the children's deficits showed no relation to hemispheric side of damage. Indeed, early cerebral damage to either hemisphere, even if extensive, resulted in relatively few and mild deficits if the damage was unaccompanied by seizure activity. By contrast, early lateralized lesions that were accompanied by a seizure disorder resulted in both a high incidence and degree of deficit that was unrelated to lesion side.