Long-term Psychosocial Outcome in Typical Absence Epilepsy

Wirrell, Elaine; Camfield, Carol; Camfield, Peter; Dooley, Joseph M.; Gordon, Kevin; Smith, Bruce R.

doi:10.1001/archpedi.1997.02170390042008

Cited by 203 publications

(158 citation statements)

References 16 publications

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“…Although some of these findings were suggested by previous smaller studies of mixed seizure populations including treated subjects, 4,27,28 this constellation of findings in this large, well-characterized, prospective cohort highlights the subtle but profound nature of this attentional comorbidity.…”

Section: Statistical Analysis Baseline Neurocognitive Test Results Asupporting

confidence: 39%

“…This is consistent with a report of a high rate of cognitive and behavioral deficits in a smaller study of 56 young adults with a history of absence seizures. 4 Our findings demonstrate a selective and robust pattern of deficits typically associated as an inattentive rather than hyperactive form of attention deficit. There were a disproportionate number of omission errors relative to commission errors, suggesting that children had a greater tendency to lose focus on the task rather than respond in an impulsive manner.…”

Section: Statistical Analysis Baseline Neurocognitive Test Results Amentioning

confidence: 55%

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Pretreatment cognitive deficits and treatment effects on attention in childhood absence epilepsy

et al. 2013

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Objective: To determine the neurocognitive deficits associated with newly diagnosed untreated childhood absence epilepsy (CAE), develop a model describing the factorial structure of items measuring academic achievement and 3 neuropsychological constructs, and determine shortterm differential neuropsychological effects on attention among ethosuximide, valproic acid, and lamotrigine.Methods: Subjects with newly diagnosed CAE entering a double-blind, randomized controlled clinical trial had neuropsychological testing including assessments of general intellectual functioning, attention, memory, executive function, and achievement. Attention was reassessed at the week 16-20 visit.Results: At study entry, 36% of the cohort exhibited attention deficits despite otherwise intact neurocognitive functioning. Structural equation modeling of baseline neuropsychological data revealed a direct sequential effect among attention, memory, executive function, and academic achievement. At the week 16-20 visit, attention deficits persisted even if seizure freedom was attained. More subjects receiving valproic acid (49%) had attention deficits than subjects receiving ethosuximide (32%) or lamotrigine (24%) (p 5 0.0006). Parental assessment did not reliably detect attention deficits before or after treatment (p , 0.0001). Conclusions:Children with CAE have a high rate of pretreatment attentional deficits that persist despite seizure freedom. Rates are disproportionately higher for valproic acid treatment compared with ethosuximide or lamotrigine. Parents do not recognize these attentional deficits. These deficits present a threat to academic achievement. Vigilant cognitive and behavioral assessment of these children is warranted.

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Section: Statistical Analysis Baseline Neurocognitive Test Results Asupporting

confidence: 39%

Section: Statistical Analysis Baseline Neurocognitive Test Results Amentioning

confidence: 55%

Pretreatment cognitive deficits and treatment effects on attention in childhood absence epilepsy

et al. 2013

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“…Adolescent boys and girls may show different sensitivities to various quality-of-life domains. Key Words: trol groups (6)(7)(8)(9). They also express more worries: adolescents with epilepsy are less interested in competitive sports, and fewer anticipate ever driving a car than do controls (7); others are concerned that epilepsy will prevent them from becoming parents or successfully employed (lo), or that seizures will kill them (11)(12)(13).…”

mentioning

confidence: 99%

Risk Factors for Poor Health‐Related Quality of Life in Adolescents with Epilepsy

et al. 1999

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Summary:Purpose: To examine potential risk factors for poor health-related quality of life (HRQOL) among adolescents with epilepsy by using the newly developed QOLIE-AD-48. Risk factors were derived from sociodemographic, social, academic, and epilepsy-and health-related domains.Methods: The QOLIE-AD-48 was administered to 197 English-speaking adolescents (age 11-17 years from >20 sites in the United States and in Canada). The self-report instrument yields an overall HRQOL score and eight subscale scores. Other data were obtained from family interviews, physician reports, and health records. Multiple regression analyses were conducted to study risk factors for impairment of HRQOL.Results: Older adolescents (age 14-17 years), those with more severe epilepsy and more symptoms of neurotoxicity, and those living in households with lower socioeconomic status were more likely to report poor overall HRQOL. Risk factors in the eight HRQOL domains were found as follows: (a) Epilepsy Impact: older age in adolescence, more severe epilepsy and neurotoxicity, more hospitalizations during the past year, and fewer hours of extracurricular activities; (b) Memory and Concentration: longer duration of epilepsy, special education classes, and history of repeating a grade in school; (c) Attitude Toward Illness: older age, female gender, and more severe epilepsy and neurotoxicity; (d) Social Support: younger age, male gender, and fewer hospitalizations in the last year; (e) Stigma: lower socioeconomic status and special-education classes; and (0 Health Perceptions: older age, female gender, and lower socioeconomic status. None of the factors examined was significantly associated with HRQOL in (g) Physical Functioning or (h) School Behavior subscales.Conclusions: We identified several risk factors for poor HRQOL outcomes in adolescents with epilepsy. Age, increased seizure severity, and neurotoxicity were most consistently associated with poor HRQOL across domains. Older adolescents, independent of epilepsy severity, reported worse overall HRQOL than did their younger counterparts. Older adolescents also were more likely to perceive a greater negative impact on life and general health, and had more negative attitudes toward epilepsy. Adolescent boys and girls may show different sensitivities to various quality-of-life domains. Key Words: HRQOL-Adolescents-QOLIE-AD-48.Adolescence, the transition from childhood to adulthood, is a period marked by puberty, novelty seeking, sexual and social identification, and solidifying personality traits. In this turbulent and fragile life stage, a chronic medical disorder, such as epilepsy, can stigmatize, and impair independence, social functions, peer relations, self-esteem, mood, and cognition (1-5). Adolescents with epilepsy have a higher frequency of behavioral problems than do healthy or chronically ill con-

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“…There has been considerable concern that the term “benign” underestimates these issues in the milder epilepsy syndromes such as benign epilepsy with centrotemporal spikes (BECTS) and childhood absence epilepsy (CAE). Despite the gestalt of a benign syndrome, BECTS may be associated with transient or long‐lasting cognitive effects33, 34 and CAE with significant psychosocial consequences such as increased risk of early pregnancy 35. The Berg et al3 report suggested new terms to distill the elements implied in the term “benign.” These are “self‐limited,” to denote the likely spontaneous resolution of a syndrome such as BECTS, and “pharmacoresponsive,” to show that it is expected that this syndrome will be controlled with the appropriate antiepileptic drugs 3…”

Section: Road Mapmentioning

confidence: 99%

Classification of the epilepsies: New concepts for discussion and debate—Special report of the ILAE Classification Task Force of the Commission for Classification and Terminology

et al. 2016

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SummaryThe ILAE Task Force on Classification presents a road map for the development of an updated, relevant classification of the epilepsies. Our objective is to explain the process to date and the plan moving forward as well as to invite further discussion about the newly proposed terms and concepts. Here, we present our response to feedback about the 2010 Organization of the Epilepsies and clarify the reintroduction of the word “classification” to map out a framework for epilepsy diagnosis. We introduce some new concepts and suggest four diagnostic levels: seizure type, epilepsy category, epilepsy syndrome, and epilepsy with (specific) etiology to denote specific levels of diagnosis. We expand the etiological categories to six, focusing on those with treatment implications. Finally, we discuss the changes in terminology originally suggested and modifications in response to comments from the epilepsy community. We welcome feedback and discussion from the global epilepsy community, particularly for the new suggested terms, so that we can cement a classification that both reflects current thinking and scientific understanding and provides a dynamic, evolving framework.

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Long-term Psychosocial Outcome in Typical Absence Epilepsy

Cited by 203 publications

References 16 publications

Pretreatment cognitive deficits and treatment effects on attention in childhood absence epilepsy

Pretreatment cognitive deficits and treatment effects on attention in childhood absence epilepsy

Risk Factors for Poor Health‐Related Quality of Life in Adolescents with Epilepsy

Classification of the epilepsies: New concepts for discussion and debate—Special report of the ILAE Classification Task Force of the Commission for Classification and Terminology

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