WASHINGTON – Children with new-onset epileptic seizures appear to have more behavior problems than do those without the disorder, David W. Dunn, M.D., said at the annual meeting of the American Academy of Child and Adolescent Psychiatry.
“We know that kids with new-onset seizures have more problems at baseline than siblings. This suggests to us that there's got to be something going on already before” children have a first seizure, said Dr. Dunn of Indiana University in Indianapolis.
The researchers enrolled 356 children aged 6–14 years who had their first recognized seizure within the past 3 months.
Their siblings, also aged 6–14 years (205), were recruited as controls. The Child Behavior Checklist (CBCL) was used to measure behavior problems. The genders were roughly equal in the group of children with seizures, and the group was largely white (83%).
“We found that it was the children with prior unrecognized seizures who had the higher scores,” Dr. Dunn said. With the CBCL, a higher score provides greater evidence of behavior problems. Children with prior unrecognized seizures had a mean CBCL total score of 57, while those with true first seizures had a mean score of 54 and siblings had a mean score of 50.
About a third of the children who have prior unrecognized seizures already measured in the clinical range of the CBCL for behavior problems.
Just over 20% of the children with true first seizures measured in the clinical range, as did 16% of the siblings.
When the researchers looked at CBCL syndrome scores, they found “the highest mean syndrome scores were in attention problems,” he said.
In fact, 15% of children with prior unrecognized seizures and 9% of children with true first seizures were in the clinical range for attention problems.
Children with prior unrecognized seizures also had significantly higher rates of aggressive behavior and anxiety/depression, as well as higher withdrawal syndrome scores, than did children with true first seizures.
Dr. Dunn theorized that this might be a problem with children having some underlying central nervous system discharge that doesn't appear on an EEG.
“We are saying that there is probably some kind of underlying central nervous system dysfunction that causes both seizures and behavior problems,” he suggested.
These findings come from a baseline analysis that is part of a larger study, which will follow the children for several years.
“Our thought was that if behavior problems were due to recurrent seizures, medication effect, or the patient's reaction to illness, we wouldn't see very many behavior problems right at the very beginning of the epilepsy but these would build up over time.
“But if the behavior problems were due to some underlying central nervous system problem, then the behavior problems should be present at the beginning of the seizures and should persist,” Dr. Dunn said.