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Analysis of related factors for neuropsychiatric comorbidities in children with epilepsy
Xin-Ying Zhang1, Meng Sun1, Jiang-Ya Wang1
1Department of Pediatrics, HeBei General Hospital, No.348 of Heping West Road, Xinhua District, Shijiazhuang, 050051, China.
Insights
Epilepsy in children poses risks to cognitive function, with disease duration, seizure frequency, status epilepticus, and antiseizure medications being key factors. Early intervention and genetic analysis are crucial for managing epilepsy and its behavioral impacts.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Neurodevelopmental Disorders
Background:
- Epilepsy is a common neurological disorder in children.
- Cognitive impairment and behavioral problems are significant comorbidities in pediatric epilepsy.
- Understanding risk factors is crucial for early intervention and improved outcomes.
Purpose of the Study:
- To identify risk factors associated with psychiatric behavior in children with epilepsy.
- To analyze the psychobehavioral conditions of children diagnosed with epilepsy.
- To investigate the relationship between epilepsy characteristics and cognitive function.
Main Methods:
- A cohort of 294 children with epilepsy was analyzed.
- Cognitive functions were assessed using standardized developmental and intelligence scales.
- Participants were categorized into groups with and without cognitive impairment for comparative analysis.
Main Results:
- Disease course, seizure frequency, status epilepticus, and the number of antiseizure medications (ASMs) were significantly associated with cognitive impairment.
- Early onset, prolonged disease duration, known etiology, and polypharmacy negatively impacted behavior, education, and social adaptability.
- No significant differences were found in age, gender, age of onset, or interictal epileptiform discharge between groups.
Conclusions:
- Disease course, seizure frequency, status epilepticus, and ASM load are significant risk factors for cognitive impairment in pediatric epilepsy.
- Early identification and management of these factors are essential for prevention and control.
- Genomic technologies and precision medicine, including gene therapy, hold promise for tailored treatment of epilepsy in children.
Objective:
To analyze the risk factors affecting psychiatric behavior and study the psychobehavioral conditions of children with epilepsy.
Method:
We randomly selected and enrolled 294 children with epilepsy who visited and were hospitalized in the pediatric clinic of Hebei General Hospital between January 2017 and January 2022, as the study participants. We comprehensively assessed their cognitive functions using the Gesell development schedule or Wechsler Intelligence Scales. The participants were divided into the study group (n = 123) with cognitive impairment and the control group (n = 171) with normal cognitive functions, for analysis.
Results:
There were statistically significant differences between the two groups in disease course, frequency of epilepsy, status epilepticus, and the number of antiseizure medications (ASMs) used (P < 0.05), while there were no statistically significant differences in age, gender, age of onset, form of onset, interictal epileptiform discharge, history of febrile convulsion, and the time from onset to initial visit (P > 0.05). Based on multivariate logistic regression analysis, the course of disease, frequency of onset, status epilepticus and number of ASMs used were identified as high-risk factors for cognitive impairment in children with epilepsy. Similarly, early onset, long course of disease, known etiology, and combination of multiple drugs have a negative impact on behavioral problems, school education, and social adaptability.
Conclusion:
The course of disease, the frequency of onset, status epilepticus, and the number of ASMs used are high-risk factors for cognitive impairment in children with epilepsy, which can be prevented and controlled early. When selecting ASMs, their advantages and disadvantages should be weighed. Moreover, the availability of alternative treatment options must be considered. With the help of genomic technology, the causes of epilepsy should be identified as early as possible, and precision medicine and gene therapy for children with epilepsy should be actively developed.
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