A Medical and Social Survey of 231 Children with Seizures

Abstract

SUMMARY Two hundred and thirty‐one children with seizures, aged 0–17 years (131 males, 100 females), were followed for a few months up to 4 years. Most of them belonged to working class families living in poor housing. In 150 cases the seizures started in the first 5 years of life, whereas only 37 were below that age when first referred to us. This contrast is discussed and some useful conclusions are drawn with regard to the parents' attitude to the child's illness. A high incidence of seizures in near relatives (38 cases), febrile convulsions (77 cases), and abnormalities during pregnancy or delivery (53 cases) was found and is discussed. The types of seizure, their frequency, medical treatment and EEG findings are described briefly. The general therapeutic approach and management are discussed in some detail, in view of the fact that in 52 cases the parents considered their child's behavioural disturbances to be the major problem. An intense, insistent and tactful case work was done by our social workers with the aim to change parental attitudes, environmental factors, when they played an important role, and to secure final rehabilitation of the patient. RÉSUMÉ On a suivi pendant une période allant de quelques mois jusqu'à 4 ans, 231 enfants âgés de 0 à 17 ans (131 garçons, 100 filles) présentant des crises. La majorité des enfants appartenait à des familles ouvrières vivant dans de pauvres habitations. Chez 150 d'entre eux, les crises ont commencé au cours des 5 premières années de vie, mais 37 seulement nous ont été envoyés pendant cette période. On discute la raison de cette disproportion et l'on tire les mêmes conclusions utiles sur l'attitude des parents vis‐à‐vis de la maladie de leurs enfants. Une fréquence élevée des crises dans la famille (38 cas), des convulsions fébriles (77 cas) et d'une pathologie de la grossesse et de l'accouchement (53 cas) a été retrouvée et discutée. On a brièvement décrit les types de crises, leur fréquence, le traitement médical et les données électroencéphalographiques. On a discuté en détail de l'attitude thérapeutique générale et du traitement approprié en tenant compte que les parents de 52 enfants considéraient que les troubles du comportement étaient le probléme le plus important. Notre équipe d'assistantes sociales a fait avec tact, un travail intense et continu pour modifier l'attitude des parents, les facteurs du milieu lorsqu'ils jouaient un rôle important, et pour assurer la réhabilitation définitive du patient.

Neuropsychological Abilities of Children with Epilepsy

“…This is reflected in the distribution by seizure type, which is skewed toward the more unusual and more difficult to control types. Gregoriades (1972), reporting on a large series of children with seizures, found that 11% had classic absence seizures, whereas only 6% of our series did. Similarly, 50% had generalized tonic-clonic seizures (only), whereas 25% of our series did.…”

Neuropsychological Functions in Idiopathic Occipital Lobe Epilepsy

“…Many studies of cognitive function in children with epilepsy have shown that their mean test scores were below that of the particular test used (21)(22)(23) and that even children with epilepsy but with no known neurologic disorder obtained lower IQ scores (24,25). Although it has been reported that children with epilepsy might have normal IQs (26) or that their IQs were not significantly different from controls (27), neuropsychological defects are not rare in children with idiopathic epilepsy who have normal IQs (26,(28)(29)(30).…”

Febrile Convulsions Followed by Nonfebrile Convulsions. A Clinical, Electroencephalographic and Follow-Up Study

“…The incidence of this development has been variously reported as 1 % (Frantzen et al 1970), 3 % (van den Berg and Yerushalmy 1969), 11% (Taylor and Ounsted 1971), 16% (Degen and Goller 1967), 26% (Sogawa and lmamura 1972), and 57% (Livingston 1954). One-quarter (Gregoriades 1972) or 40% (Patrick and Levy 1924) of epileptic patients suffered from febrile convulsions in their early childhood.…”