Piyasil Vinadda, Sriudomkajorn Somjit, Suwanpairat Janwanpen
Queen Sirikit National Institute of Child Health, Department of Medical Services, College of Medicine, Rangsit University, Bangkok, Thailand.
J Med Assoc Thai. 2008 Oct;91 Suppl 3:S9-14.
Neurological diseases and psychiatric problems were cloudily related. Many patients with epilepsy had associated problems such as Learning disorders (LD) or Attention deficit hyperactivity disorder (ADHD). Evaluation and treatments of these behavioral and learning problems should be, therefore, included in management of patients with epilepsy in order to improve their quality of life.
To study behavioral, learning problems that indicate ADHD in epileptic children.
These was cross sectional study in 100 epileptic children, age 6- 11-years-old who visited Neurological Clinic at Queen Sirikit National Institute of Child Health. The patients were assessed with Thai Youth Checklist (TYC), IOWA screening test for ADHD and questionnaires concerning learning area. The data was analyzed in Chi-square, using SPSS program.
The prevalence of behavioral problems in epileptic children was 57 percent. The prevalence of moderate to severe ones which should be treated and related to complex partial seizure was 32 percent. The prevalence of learning problems was 23 percent. Most were found in higher classes. The prevalence of behaviors that indicate ADHD was 23 percent from TYC and 58 percent from IOWA screening test for ADHD. There was relationship of behaviors that indicate ADHD and the severity of epilepsy. The prevalence of delinquent behavior was 24 percent and social problems were 32 percent respectively. Correlation of behavioral problems and social skills (p = 0.027), good manner toward parents (p = 0.015) and helping house chores (p = 0.016) were significantly different. However there was no significantly different between behavioral problems and age of onset as well as duration of epileptic symptom, frequency of seizures in the past 6 months, EEG results and combination of medication.
The epileptic children had high risks of behavioral and learning problems; they may be prevented by intensive evaluation, proper interventions, adequate counseling, proper medication, parental training and proper rehabilitation.
神经疾病与精神问题存在模糊的关联。许多癫痫患者伴有诸如学习障碍（LD）或注意力缺陷多动障碍（ADHD）等相关问题。因此，这些行为和学习问题的评估与治疗应纳入癫痫患者的管理中，以提高他们的生活质量。
研究癫痫儿童中提示ADHD的行为和学习问题。
这是一项对100名6至11岁癫痫儿童进行的横断面研究，这些儿童前往诗丽吉王后国家儿童健康研究所神经科门诊就诊。使用泰国青少年检查表（TYC）、爱荷华州ADHD筛查测试以及有关学习领域的问卷对患者进行评估。数据采用SPSS程序进行卡方分析。
癫痫儿童行为问题的患病率为57%。应予以治疗且与复杂部分性发作相关的中度至重度行为问题的患病率为32%。学习问题的患病率为23%。大多数出现在高年级。根据TYC提示ADHD的行为患病率为23%，根据爱荷华州ADHD筛查测试为58%。提示ADHD的行为与癫痫严重程度之间存在关联。违纪行为的患病率分别为24%，社会问题为32%。行为问题与社交技能（p = 0.027）、对父母的良好态度（p = 0.015）以及帮助做家务（p = 0.016）之间的相关性存在显著差异。然而，行为问题与发病年龄、癫痫症状持续时间、过去6个月的癫痫发作频率、脑电图结果以及药物组合之间没有显著差异。
癫痫儿童存在行为和学习问题的高风险；可通过强化评估、适当干预、充分咨询、合理用药、家长培训和适当康复来预防。
