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Behavior problems in children before first recognized seizures
J K Austin1, J Harezlak, D W Dunn
1Schools of Nursing, Indiana University, Indianapolis, Indiana. joausti@iupui.edu
Insights
Behavioral problems are common in children with epilepsy, even before their first recognized seizure. Early, unrecognized seizures and epilepsy type are linked to these issues, suggesting epilepsy is a pervasive condition.
Area of Science:
- Pediatric Neurology
- Child Psychology
- Epilepsy Research
Background:
- Behavioral problems in children with epilepsy are not well understood regarding their onset.
- Identifying the timing and factors associated with these problems is crucial for early intervention.
Purpose of the Study:
- To determine the prevalence of behavioral problems in children with epilepsy prior to their first recognized seizure.
- To compare behavioral issues between children with epilepsy and their healthy siblings.
- To identify early seizure-related variables associated with behavioral problems.
Main Methods:
- A study involving 224 children (4-14 years) with a first recognized seizure and 135 healthy siblings.
- Computer-assisted telephone interviews with mothers using the Child Behavior Checklist to assess behavioral problems.
- Statistical analyses included frequencies, t tests, correlational analysis, and multiple regression.
Main Results:
- Elevated rates (32.1%) of behavioral problems were observed in children with epilepsy in the 6 months preceding their first recognized seizure.
- Children with prior unrecognized seizures showed higher rates (39.5%) of behavioral problems.
- Children with epilepsy exhibited significantly more Total, Internalizing, Attention, Thought, and Somatic Complaints problems than healthy siblings.
Conclusions:
- Children with previously unrecognized seizures face an elevated risk for behavioral problems at the time of their first recognized seizure.
- These findings support the concept of epilepsy as a condition encompassing both seizures and behavioral difficulties.
Objective:
It is not known when behavior problems begin in children with epilepsy. The purposes of this study were to: 1) describe the rates of behavior problems in children before their first recognized seizure, 2) determine the differences in behavior problems between children with a first recognized seizure and their healthy siblings, and 3) identify the seizure variables early in the course of the condition that are associated with behavior problems before the first recognized seizure.
Methods:
The sample was 224 children (4-14 years old) with a first recognized seizure and their 135 healthy siblings. As part of a larger study, computer-assisted structured telephone interviews were conducted with mothers to measure child and sibling behavior problems. Behavior problems were measured using the Child Behavior Checklist. Frequencies, t tests, correlational analysis, and multiple regression were used to analyze data.
Results:
Higher than expected rates of behavior problems in the 6 months before the first recognized seizure were found in the total seizure sample, with 32.1% being in the clinical or at-risk range. Rates were highest in children who had previous events that were probably seizures, with 39.5% in the clinical or at-risk range. Children with seizures had significantly higher Total, Internalizing, Attention, Thought, and Somatic Complaints problem scores than their nearest-in-age healthy siblings. Within the seizure sample, variables significantly associated with behavior problems after adjusting for research site, child sex, child age, and socioeconomic status (as represented by primary caregiver's education) were interactions of previously unrecognized seizures with gender and epilepsy syndrome/type of seizures.
Conclusions:
Children with previously unrecognized seizures are already at increased risk for behavior problems at the time of their first recognized seizure. These findings are consistent with the hypothesis that in some children, epilepsy is a pervasive condition that includes both seizures and behavioral problems.
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