Neuropsychological and behavioural aspects in children and adolescents with idiopathic epilepsy at diagnosis and after 12 months of treatment

Piccinelli, Paolo; Beghi, Ettore; Borgatti, Renato; Ferri, Matteo; Giordano, Laura; Romeo, Antonino; Termine, Cristiano; Viri, Maurizio; Zucca, Claudio; Balottin, Umberto

doi:10.1016/j.seizure.2010.07.014

Cited by 37 publications

(24 citation statements)

References 50 publications

(60 reference statements)

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“…These early behavior problems are consistent not only with our past research (3) but with recent research by others (30). We also replicated past findings showing that children who had had prior unrecognized seizures are especially at risk for behavior problems (3).…”

Section: Methodssupporting

confidence: 93%

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Behavior problems in children at time of first recognized seizure and changes over the following 3years

Austin¹,

Perkins²,

Johnson³

et al. 2011

Epilepsy & Behavior

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Objectives The purposes of this 36-month study of children with first recognized seizures were: (a) to describe baseline differences in behavior problems between children with and without prior unrecognized seizures; (b) to identify differences over time in behavior problems between children with seizures and their healthy siblings, (c) to identify the proportion of children with seizures and healthy siblings who were consistently at risk for behavior problems for 36 months; and (d) to identify risk factors for behavior problems 36 months following the first recognized seizure. Risk factors explored included demographic (child age and gender, caregiver education), neuropsychological (IQ, processing speed), seizure (epileptic syndrome, use of antiepileptic drug AED, seizure recurrence) and family (family mastery, satisfaction with family relationships, parent response) variables. Methods Participants were 300 children ages 6 through 14 years with a first recognized seizure and 196 healthy siblings. Data were collected from medical records, structured interviews, self-report questionnaires, and neuropsychological testing. Behavior problems were measured using the Child Behavior Checklist and the Teacher’s Report Form. Data analyses included descriptive statistics and linear mixed models. Results Children with prior unrecognized seizures were at higher risk for behavior problems at baseline. As a group, children with seizures showed a steady reduction in behavior problems over time. Children with seizures were found to have significantly more behavior problems than their siblings over time and significantly more children with seizures (11.3%) than siblings (4.6%) had consistent behavior problems over time. Key risk factors for child behavior problems based on both caregivers and teachers were: less caregiver education, slower initial processing speed, slowing of processing speed over the first 36 months, and a number of family variables including lower levels of family mastery or child satisfaction with family relationships, lower parent support of the child’s autonomy, and lower parent confidence in their ability to discipline their child. Conclusions Children with new-onset seizures who are otherwise developing normally have higher rates of behavior problems than their healthy siblings; however, behavior problems are not consistently in the at-risk range in most children during the first three years after seizure onset. When children show behavior problems, family variables that might be targeted include family mastery, parent support of child autonomy, and parent confidence in their ability to handle their children’s behavior.

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Section: Methodssupporting

confidence: 93%

“…These findings are consistent with a recent review of literature on psychopathology in children with epilepsy (33) and with recent studies of children with epilepsy (30, 34). Attention problems have been investigated using instruments designed to more delineate the specific nature of attention difficulties (11, 31).…”

Section: Methodssupporting

confidence: 92%

Behavior problems in children at time of first recognized seizure and changes over the following 3years

Austin¹,

Perkins²,

Johnson³

et al. 2011

Epilepsy & Behavior

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show abstract

“…The nature of neurocognitive impairment in children with epilepsy is not clear -there are a large number of concomitant studies and results. Many studies have found dysfunction in attention [29][30][31], memory [32,33], and executive functions [29]. There are also studies that have found dysfunction in visuospatial [34] and verbal skills [30].…”

Section: Neurocognitive Performance In Children With Epilepsymentioning

confidence: 99%

Relationship between social competence and neurocognitive performance in children with epilepsy

Raud

Kaldoja

Kolk

2015

Epilepsy & Behavior

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“…11 Thus, given the potential for AEDs to negatively impact behavior, in particular aggressive behavior, 12,13 it is essential that behavioral safety profiles of AEDs in the pediatric setting are fully characterized.…”

mentioning

confidence: 99%

Adjunctive perampanel in adolescents with inadequately controlled partial‐onset seizures: A randomized study evaluating behavior, efficacy, and safety

et al. 2016

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SUMMARYObjective: The noncompetitive a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist perampanel was shown in phase III trials to be an effective and well-tolerated adjunctive treatment for partial-onset seizures. In adolescents, it is necessary to characterize cognitive, neuropsychological, and behavioral side effects of antiepileptic drugs (AEDs). The current analysis focuses on behavioral outcomes, efficacy, and safety of perampanel in adolescents. Methods: Adolescents (12-17 years) on a stable regimen of 1-3 AEDs for partial-onset seizures were randomized (2:1 ratio) to receive up to 12 mg/day perampanel or placebo. Alongside efficacy, cognitive, and neuropsychological assessments, behavioral outcomes were measured with the Child Behavior Checklist (CBCL) before and after a 19-week titration and maintenance phase. Results: Of the randomized patients, 85 received perampanel and 48 received placebo. Median reduction in seizure frequency from baseline was 58.0% for perampanel and 24.0% for placebo (p = 0.079). More patients had seizure frequency reduced by 50% after perampanel (n = 49 [59.0%]) than placebo (n = 17 [37.0%]; p = 0.0144). Changes in behavior were minimal, and there were no differences between groups on competency (p = 0.619) or problems (p = 0.174). A greater proportion of placebo patients were classified in the CBCL "clinical" range for competency at end of treatment, whereas the number in the perampanel group remained unchanged. The overall safety profile was similar to that reported previously for perampanel; most frequently reported adverse events (AEs) were dizziness (26 patients [30.6% vs. 14.6% placebo]), somnolence (13 patients [15.3% vs. 4.2%]), and headache (nine patients [10.6% vs. 14.6%]). Aggression was reported in seven patients receiving perampanel (8.2% vs. 2.1% placebo); two of these were serious AEs, with neither requiring treatment discontinuation. Significance: Adjunctive perampanel is efficacious and well tolerated in adolescents with partial-onset seizures, and appears to have no clinically important impact on behavior measured using the CBCL.

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Neuropsychological and behavioural aspects in children and adolescents with idiopathic epilepsy at diagnosis and after 12 months of treatment

Abstract: Idiopathic epilepsy can affect attention, even before starting treatment. Emotional and behavioural difficulties and a low socio-economical status are associated with cognitive impairment.

Cited by 37 publications

References 50 publications

Behavior problems in children at time of first recognized seizure and changes over the following 3years

Behavior problems in children at time of first recognized seizure and changes over the following 3years

Relationship between social competence and neurocognitive performance in children with epilepsy

Adjunctive perampanel in adolescents with inadequately controlled partial‐onset seizures: A randomized study evaluating behavior, efficacy, and safety

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