Psychobehavioral disturbance in epileptic children

Abstract

Psychobehavioral disturbances are frequently seen in epileptic children, but they vary in type and degree. This diversity depends on various factors: age at onset, type of epileptic syndrome and EEG pattern, and the drugs used. The early onset of an epileptic process (within the first year of life) has a profound effect on the organization of primary relational processes and on structuring of the ego. The cognitive and behavioral damage that results may become evident after just a few seizures and may persist through time when such damage is not definitive. Epilepsy with onset in childhood may be accompanied by practognosic deficits and impairment of memory, attention and analytical reasoning. These deficits occur much more frequently in the symptomatic forms. In adolescent forms of epilepsy prevalently idiopathic, disturbances of a neurotic type are relatively common. Psychobehavioral disturbances tied to drugs can be noticed mainly with the use of phenobarbital (hyperactivity, longer reaction times), phenytoin (torpor), and politherapy.

Brain function in children with untreated epilepsy: Relationship to biomarkers of brain damage

“…This results This study showed an increasing risk of lower intelligence and poor cognitive performance in children with repeated unprovoked seizures regardless of the seizure type, particularly in the presence of higher seizure frequency and severe epileptogenic EEG abnormalities. In accordance, cognitive or behavioral abnormalities were found to be more common in the pediatric population with epilepsy and associated with impairment of memory and ability for new learning, inattention, specific deficits in visuoperceptual domain and visualmotor speed, impairments in executive function, behavioral changes and poor scholastic achievement (5)(6)(7)(8)(9)(10). The etiology of cognitive deficits with epilepsy is multifactorial, being affected by the genetics, type, frequency and severity of seizures, age of onset, duration of illness, location of the epileptogenic lesion, underlying brain abnormality, epileptic syndrome type, and psychosocial issues [14,15,17,43].…”

“…It has been shown that seizures selectively impair myelin formation as their effect on brain growth [4,5]. The presence of epilepsy and its treatment during a period of maximal white-matter growth could result in impairment in spatial learning, memory processes and other aspects of cognition [6][7][8][9][10]. Cognitive impairment even if trivial may adversely affect the child's psychosocial functioning in daily life as educational skills and learning tasks.…”

Psychosocial and neuropsychological function in children with epilepsy

“…L eonard and M. R. M. George ures have no neurocognitive de® cits [42]. Even if seizures are well controlled, children and adolescents with epilepsy may function less well than expected in school, family and community activities.…”

“…Depending on the relative vulnerability of various parts of the brain and individual susceptibility, the consequences of epileptiform discharges may be di erent even if the age of onset, seizure type, severity and duration all appear to be the same [44]. Cognitive disturbances in epileptic children vary depending on the age of onset, seizure type, EEG pattern and selection of anticonvulsants [42].…”

Incidence of Postoperative Epilepsy in Children following Subfrontal Craniotomy for Tumor

“…Both phénobarbital and phenytoin may cause cognitive and behavioral deficits in children. Phénobarbital has been shown to cause hyperac tivity, lowering of IQ, and clinical depression [16][17][18][19], Phenytoin can also lower IQ and may be associated with a progressive encephalopathy [17,20,21]. In addi tion, it causes gingival hyperplasia, hirsutism, coarsening of facial features, and is teratogenic [22,23].…”