Not Only a Matter of Epilepsy: Early Problems of Cognition and Behavior in Children With “Epilepsy Only”—A Prospective, Longitudinal, Controlled Study Starting at Diagnosis

Abstract

Already in the earliest stage of the illness, children with epilepsy are liable to vicissitudes in cognitive and behavioral functioning. Contextual variables are all-important.

Determinants of Social Outcomes in Adults With Childhood-onset Epilepsy

“…In children with uncomplicated epilepsy, there is also ample evidence demonstrating an increased level of subtle cognitive as well as psychiatric and behavioral problems relative to healthy controls, which could also influence adult outcomes. [8][9][10][11][12][13] The respective impacts of seizure course versus learning and psychiatric problems on adult outcomes have not been distinguished. Understanding what places a child with epilepsy at risk for poorer outcomes in adulthood might contribute to management of childhood epilepsy, determining the need for early educational and psychiatric/psychological services, and planning pediatric to adult transition and transfer of care.…”

Possíveis interfaces entre TDAH e epilepsia

“…De modo semelhante, em outro estudo que incluiu 173 crianças com epilepsia crônica, foi documentado um pior desempenho em medidas neuropsicológicas da atenção e da velocidade de processamento na casuística de epilépticos 46 . Oostrom et al 47 , contrariando estudos anteriores, usaram uma extensa bateria de testes neuropsicológicos e perceberam que crianças com epilepsia recém-diagnosticada e crises não complicadas apresentavam mais problemas na avaliação neuropsicológica que o grupo de controle. Entretanto, seus problemas relacionados à atenção eram, em geral, transitórios e não apresentavam relação direta com fatores relativos às crises.…”

“…Os erros mais frequentes foram em testes de flexibilidade cognitiva e atenção sustentada. Os pacientes com dificuldades escolares prévias ao início da epilepsia e aqueles cujos pais reagiram de forma menos adaptada ao diagnóstico tiveram um pior desempenho, de forma que os autores concluíram que variáveis relacionadas à epilepsia não justificavam os achados 47 .…”

Academic performance in children with new-onset seizures and asthma: A prospective study

“…Williams et al (19) found no differences in performance on cognitive measures between children with new-onset seizures before and after six months of treatment with AEDs compared to children with recently diagnosed diabetes mellitus. Increased seizure frequency has been negatively related to performance in some studies (7,(23)(24)(25)(26), although other studies found that seizure variables were not strongly related to academic achievement (2,4,14,27).To more clearly define the etiology and natural history of academic difficulties, longitudinal studies beginning early in the course of the seizure disorder are needed. To date, only four studies have examined academic problems among children with new-onset seizures, and in two of the studies (4,14) data on children with both new-onset and chronic seizures were combined and not reported separately.…”

“…They did not obtain specific measures of each child's academic performance. The final study by Oostrom and colleagues (27,29) compared children enrolled in regular school classrooms who had experienced two or more unprovoked idiopathic or cryptogenic seizures within the past year with gender-matched classmate normal controls. They found that children with epilepsy scored significantly worse on academic skills (reading, writing, and math) than controls and, over the year following entry into the study, a decline in these skills was found.…”