Controlling seizures often lessens behavioral and neuropsychological problems that are ubiquitous in children with refractory epilepsy, said Marc Boel, M.D., of University Hospitals Gasthuisberg, Leuven, Belgium.
Among 573 such children seen in his clinic, 80% showed behavioral problems, and 15% showed significant mental decline related to their epilepsy. About half of the entire group had an IQ of below 50 (Eur. J. Pediatr. Neurol. 2005;8:291-7).
Most of the children had either partial epilepsy (29%) or secondary generalized tonic-clonic epilepsy (25%). About 4% had Lennox-Gastaut syndrome. Other diagnoses included absence epilepsy, photosensitive epilepsies, tuberous sclerosis, West syndrome, severe myoclonic epilepsy of infancy, and continuous spike waves during slow-wave sleep.
The most frequent neurobehavioral disorders were pervasive developmental disorder (8%); attention-deficit hyperactivity disorder (7.5%); loss of self-esteem (9%), and self-induction of seizures (7%). Psychosis, anxiety disorders, intermittent explosive disorder, and cursive seizures were seen at lower rates.
Seizure control helps reduce those symptoms, Dr. Boel said. In 101 of the 220 children who achieved seizure control, behavioral problems disappeared or were minimized. Seizure control had only a limited effect on those patients with psychosis, pervasive developmental disorder, or attention disorders.