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[Prognostic value of hyperkinetic syndrome in children with epilepsy]
1Universitäts-Kinderklinik und Poliklinik, Jussuf Ibrahim.
Insights
Children with epilepsy, especially those with hyperactivity or intractable seizures, may experience significant declines in intellectual function. Early intervention and effective treatment are crucial for preserving cognitive development in pediatric epilepsy patients.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
Context:
- Epilepsy in children under 6 years old presents unique challenges.
- Behavioral disturbances, including hyperactivity, are common comorbidities.
- Assessing cognitive development alongside seizure control is vital.
Purpose:
- To investigate the relationship between hyperactivity, intellectual test scores, and antiepileptic drug (AED) therapy efficacy in children with epilepsy.
- To evaluate changes in cognitive function over time in relation to seizure characteristics and behavioral issues.
Summary:
- This retrospective study analyzed 43 children with epilepsy, all experiencing their first seizure before age 6.
- Hyperactivity was present in 20 patients, and 26 had intractable seizures.
- Cognitive decline (IQ < 85) was observed in 10 patients, with a significant IQ drop (>10 points) in 20 patients, particularly those with hyperactivity and/or intractable seizures.
Impact:
- Findings highlight a concerning trend of cognitive decline in pediatric epilepsy, especially with hyperactivity and intractable seizures.
- Suggests a need for integrated management strategies addressing both seizures and behavioral/cognitive aspects.
- Emphasizes the importance of long-term neurodevelopmental monitoring in children with epilepsy.
Abstract:
In a retrospective study the data of 43 children suffering from epilepsy were analysed. The first epileptic seizure was observed in all patients before the age of 6 years. The relationship between behavioral disturbances with hyperactivity, developmental respectively intellectual test scores, and efficiency of antileptic drug therapy have been investigated. Psychological testings were performed two times, at first after the start of drug therapy, and a second time after a period of 1 year 11 months in average. There were behavioral disturbances with hyperactivity in 20 patients. The epileptic seizures were intractable in 26 patients. The developmental respectively intellectual test scores have decreased to values below 85 in 7 patients with and 3 patients without hyperactivity. There was a decline by more than 10 points of the IQ score between first and second psychological testings in 16 patients with and 4 patients without hyperactivity, respectively in 17 patients with intractable seizures, but in one child only with prompt cessation of epileptic seizures. An increasing retardation of mental development was seen in children with hyperactivity at the start of seizures, in children with intractable seizures, but especially in patients with a combination of intractable seizures and hyperactivity.