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Published on: September 20, 2024
Multidisciplinary approach to childhood epilepsy: exploring the scientific rationale and practical aspects of
Joshua Goldstein1, Sigita Plioplys, Frank Zelko
1Epilepsy Center, Children's Memorial Hospital, Northwestern University, Chicago, IL 60614, USA. jgoldstein@childrensmemorial.org
Insights
Managing childhood epilepsy involves addressing comorbidities like psychiatric issues and learning difficulties, which often share genetic links with seizures. Optimal care requires a multidisciplinary approach beyond just seizure control.
Area of Science:
- Pediatric Neurology
- Neurogenetics
- Developmental Psychology
Background:
- Childhood epilepsy management extends beyond seizure control.
- Comorbidities such as psychiatric disorders and developmental delays are frequent.
- Genetic factors influencing seizure susceptibility may also underlie comorbidities.
Purpose of the Study:
- To highlight the importance of managing comorbidities in childhood epilepsy.
- To emphasize the bidirectional relationship between epilepsy and comorbid conditions.
- To advocate for a comprehensive, multidisciplinary approach to care.
Main Methods:
- Review of genetic links between epilepsy and comorbidities.
- Analysis of antiepilepsy drug effects on cognitive and behavioral aspects.
- Discussion of the role of various healthcare professionals in management.
Main Results:
- Mutations in ion channels (potassium, calcium, sodium) are associated with epilepsy syndromes and behavioral abnormalities.
- Antiepilepsy drugs can have varying effects on cognitive function and mood.
- Multidisciplinary team involvement is crucial for optimal outcomes.
Conclusions:
- Comprehensive management of childhood epilepsy necessitates addressing comorbidities.
- A holistic approach involving neuropsychological evaluation and allied health professionals is vital.
- Child neurologists can lead multidisciplinary teams in various settings.
Abstract:
The management of childhood epilepsy requires attention to more than seizure control because children with epilepsy often suffer from comorbidities that lead to an increased frequency of psychiatric disease, learning difficulties, and other problems of psychosocial development. These comorbidities can stem in part from the same genetic traits that determine seizure susceptibility. Thus, mutations affecting potassium, calcium, and sodium channels have been linked with epilepsy syndromes and affective and behavioral abnormalities. It is important to consider the effect of antiepilepsy drugs on comorbid conditions and the effect on seizures of drugs used to treat comorbidities. A number of antiepilepsy drugs are available that have minimal adverse cognitive effects, and some can have positive effects on mood and behavior. Epilepsy in a child is a condition that affects and is affected by the entire family situation. In addition to appropriate neuropsychologic evaluation, optimal management of childhood epilepsy also can require the involvement of the social worker, advanced practice nurse, and educational specialist. Many elements of the multidisciplinary team approach can be instituted by the child neurologist in community practice and at large, specialized epilepsy centers.
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