Behavioral Problems in Children with Benign Childhood Epilepsy With Centrotemporal Spikes Treated and Untreated with Antiepileptic Drugs

Abstract

The aim of this study was to investigate behavioral problems in two groups of children with benign childhood epilepsy with centrotemporal spikes (BECTS), i.e., those treated with antiepileptic drugs and those not treated in order to identify the factors associated with behavioral problems. Material and Methods. In total, 20 newly diagnosed untreated, 23 treated patients with BECTS, and 20 patients with acute/subacute peripheral nervous system disorders as a comparison group (aged 6–11 years) were examined. The evaluation was performed using the Lithuanian version of the Child Behavior Checklist (CBCL). Schooling parameters, clinical parameters, EEG parameters, and their relation to the results of the CBCL were also investigated. Results. The treated patients with BECTS had significantly higher scores in the subscales of Social Problems, Anxious/Depressed, Aggressive Behavior, and Attention Problems compared with the scores of the patients with peripheral nervous system disorders. A significant relationship was established between the scores of native language grades and Attention Problems; grades in mathematics and treatment duration; and age when the first seizure occurred and Delinquent Behavior in the group of treated patients. The duration of epilepsy was positively correlated with the scores in the subscales of Withdrawn and Delinquent Behavior. The presence of additional extrarolandic focus and spread of focal specific discharges to the centrofrontotemporal and centroparietotemporal areas were related to higher scores in Social Problems, Attention Problems, and Delinquent Behavior in the group of the treated patients with BECTS. Conclusions. Children with BECTS, especially those treated and with a longer epilepsy course, were found to be at risk of behavioral problems. Lower grades were associated with a longer disease course and medications. The presence of extrarolandic discharges was related to higher CBCL scores in the group of the treated patients with BECTS.

Systematic review of the screening, diagnosis, and management of ADHD in children with epilepsy. Consensus paper of the Task Force on Comorbidities of the ILAE Pediatric Commission

“…A Tanzanian‐based study found no evidence of behavior exacerbation with AEDs, including phenobarbital, but assessments were based solely on parental feedback, and access to AEDs was limited, with only 48% of the study group receiving therapy This is supported by studies from resource‐equipped settings as well. In contrast, other studies reported that patients with CECTS on AEDs were more likely to have social problems, aggressive behavior, and attention problems and be anxious/depressed . The study group alluded that this finding was related to ongoing seizures rather than specifically AEDs.…”

Evaluation of levetiracetam and valproic acid as low-dose monotherapies for children with typical benign childhood epilepsy with centrotemporal spikes (BECTS)

“…2 However, the frequently recurring seizures, neuropsychological dysfunctions and behavioral abnormalities encountered in children with BECTS are factors that favor prophylaxis with antiepileptic drugs (AEDs). [3][4][5][6] When treatment is planned, priority should be given to monotherapies with agents that have established antiepileptic effects and whose adverse effects are clearly understood. 7 Levetiracetam (LEV) has recently been considered as the initial monotherapy for typical BECTS.…”

Changes in functional organization and functional connectivity during story listening in children with benign childhood epilepsy with centro-temporal spikes

“…The prognosis for seizure outcome in BECTS is excellent; most patients have less than 10 seizures, and seizure activity is expected to cease by adulthood (Blom & Heijbel, 1982; Camfield & Camfield, 2002; Dalla Bernardina, Sgro, & Fejerman, 1995; Loiseau, Duche, Cordova, Dartigues, & Cohadon, 1988; Panayiotopoulos, 1999). However, a growing body of literature has documented subtle cognitive and/or behavioral problems in children with BECTS, particularly affecting language function (Baglietto et al, 2001; Danielsson & Petermann, 2009; Ebus, Overvliet, Arends, & Aldenkamp, 2011; Goldberg-Stern et al, 2010; Jurkeviciene et al, 2012; Northcott et al, 2005; Overvliet, Aldenkamp, Klinkenberg, Nicolai, et al, 2011; Overvliet, Besseling, van der Kruijs, et al, 2013; Overvliet, Besseling, et al, 2011; Samaitiene, Norkuniene, Jurkeviciene, & Grikiniene, 2012; Samaitiene, Norkuniene, Tumiene, & Grikiniene, 2013; Verrotti, Filippini, Matricardi, Agostinelli, & Gobbi, 2014; Volkl-Kernstock, Bauch-Prater, Ponocny-Seliger, & Feucht, 2009). …”