A case-control study comparing auditory and speech outcomes after cochlear implantation in children with and without seizure history.

BACKGROUND: The outcomes of pediatric cochlear implantation (CI) in children with epilepsy have not been thoroughly characterized. AIMS/OBJECTIVES: To compare auditory and speech outcomes in pediatric CI recipients with and without epilepsy, and to evaluate whether the presence of epilepsy should contraindicate CI. MATERIALS AND METHODS: This retrospective case-control study included children aged 2-6 years, comprising 23 with epilepsy (cases) and 25 without epilepsy (controls). Outcomes were evaluated using the Categories of Auditory Performance (CAP; scale 0-7) and Speech Intelligibility Rating (SIR; scale 1-5) at 6 and 12 months following implantation. Repeated-measures models with bootstrap validation were employed to account for within-subject correlations. RESULTS: The control group attained significantly higher absolute scores on the CAP and SIR scales (p < 0.001). Nevertheless, the epilepsy group exhibited substantial improvement, particularly with greater relative gains in auditory perception during the second six-month interval. CONCLUSIONS: Epilepsy is associated with reduced postoperative performance; however, it does not preclude substantial benefits from CI. SIGNIFICANCE: Children with epilepsy should not be excluded from cochlear implant candidacy solely on the basis of anticipated lower performance scores.