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Published on: September 20, 2024
Behavioral and emotional problems in children with epilepsy
Michael Freilinger1, Barbara Reisel, Edith Reiter
1Department of Pediatrics, Vienna University Hospital, Austria. michael.freilinger@meduniwien.ac.at
Insights
Behavioral and emotional problems are common in children with epilepsy. Factors like epilepsy cause, age of onset, and multiple medications are linked to these issues.
Area of Science:
- Pediatric Neurology
- Child Psychology
- Epileptology
Background:
- Behavioral and emotional problems are frequently observed in children with epilepsy.
- Understanding the link between epilepsy-related factors and these issues is crucial for comprehensive care.
Purpose of the Study:
- To assess behavioral and emotional problems in children with epilepsy.
- To investigate associations between specific problems and medical epilepsy-related factors.
Main Methods:
- Utilized the Child Behavior Checklist (CBCL) for parent-reported assessments.
- Evaluated 108 children (5-18 years) with various epilepsy syndromes.
- Recorded epilepsy-related factors: etiology, age at onset, seizure type, prognosis, frequency, EEG, and anticonvulsive therapy.
Main Results:
- 22.2% of patients exhibited moderate to severe behavioral/emotional problems (CBCL total score).
- Higher CBCL scores correlated with etiology, age at onset, and polypharmacy.
- Symptomatic epilepsy and earlier onset linked to higher Social Problem scores.
- Anticonvulsive polytherapy associated with increased Social Problems, Attention Problems, and Aggressive Behavior scores.
- No significant associations found with seizure symptoms, frequency, or EEG.
Conclusions:
- Behavioral and emotional issues are prevalent in pediatric epilepsy.
- Specific epilepsy-related factors significantly correlate with these problems.
- Psychosocial support should be integrated into routine epilepsy management for children.
Abstract:
The principal purpose of this study was to assess behavioral and emotional problems in children with epilepsy to investigate if specific behavioral and emotional problems are associated with specific medical epilepsy-related factors. The Child Behavior Checklist (CBCL) was used to assess parent-reported behavioral and emotional problems in 108 5- to 18-year-old children with various epilepsy syndromes. Specific medical epilepsy-related factors, such as etiology, age at onset, seizure symptoms, prognosis, seizure frequency, electroencephalography (EEG), and anticonvulsive therapy, were recorded during a regular follow-up examination in our pediatric outpatient epilepsy clinic, and 22.2% of our patients showed moderate to severe behavioral or emotional problems as measured by the Child Behavior Checklist total score. Higher Child Behavior Checklist scores were associated with such specific medical epilepsy-related factors as etiology, age at onset, and polypharmacy. Higher scores on the Social Problem scale were associated with symptomatic epilepsy syndromes and an earlier age at onset. Higher scores on the Social Problems, Attention Problems, and Aggressive Behavior scales were associated with anticonvulsive polytherapy. There were no statistically significant associations between the Child Behavior Checklist scores and seizure symptoms and frequency and EEG at the time of evaluation. The demonstrated frequency of behavioral and emotional problems in children with epilepsy suggests the necessity to address psychosocial issues during the course of clinical treatment.
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