Zhao Qianqian, Rathouz Paul J, Jones Jana E, Jackson Daren C, Hsu David A, Stafstrom Carl E, Seidenberg Michael, Hermann Bruce P
Departments of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Dev Med Child Neurol. 2015 Jan;57(1):37-44. doi: 10.1111/dmcn.12549. Epub 2014 Jul 10.
To characterize the prospective trajectory of parent-reported behavior and social competence problems in children with new or recent onset epilepsy from diagnosis to 5 to 6 years after diagnosis compared to healthy control participants.
Thirty-five children (21 males, 14 females; mean age 14y 1mo [SD 3y 4mo] range 8-18y) with new/recent onset idiopathic generalized (IGE) and 34 children with localization-related epilepsies (LRE; 19 males, 15 females; mean age 10y 8mo [SD 2y 2mo] range 8-18y) underwent behavioral assessment (Child Behavior Checklist) at baseline, 2 years, and 5 to 6 years after diagnosis. The assessment comprised the summary scales Total Behavior Problems Internalizing Problems, Externalizing Problems, and Total Competence. Sixty-two children with normal development served as comparison participants. Analyses were based on random effects regression modeling comparing trajectories with respect to time since epilepsy diagnosis among groups.
Differences in parent-reported behavioral problems between LRE and IGE syndrome groups and healthy comparison participants were detectable at or near the time of diagnosis and remained either stable (competence) or tended to abate (behavior problems) over the ensuing 5 to 6 years without evidence of progressive worsening. These trends were evident for both LRE and IGE groups, with no differences between them.
Behavior and competence problems in children with LRE and IGE are not characterized by progressive worsening over a 5- to 6-year period. Behavioral problems are present near the time of diagnosis and tend to abate over time, with competence problems being more persistent across serial assessments, and present in both LRE and IGE groups.
描述新发病或近期发病的癫痫儿童从诊断到诊断后5至6年家长报告的行为和社交能力问题的预期轨迹,并与健康对照参与者进行比较。
35名新发病/近期发病的特发性全身性癫痫(IGE)儿童(21名男性,14名女性;平均年龄14岁1个月[标准差3岁4个月],范围8 - 18岁)和34名局灶性相关性癫痫(LRE;19名男性,15名女性;平均年龄10岁8个月[标准差2岁2个月],范围8 - 18岁)在基线、诊断后2年以及诊断后5至6年接受了行为评估(儿童行为量表)。评估包括总行为问题、内化问题、外化问题和总能力的总结量表。62名发育正常的儿童作为对照参与者。分析基于随机效应回归模型,比较各组自癫痫诊断以来随时间的轨迹。
在诊断时或接近诊断时可检测到LRE和IGE综合征组与健康对照参与者之间家长报告的行为问题存在差异,在随后的5至6年中这些差异保持稳定(能力方面)或趋于减轻(行为问题方面),没有进行性恶化的证据。LRE组和IGE组均呈现这些趋势,两组之间无差异。
LRE和IGE儿童的行为和能力问题在5至6年期间并非以进行性恶化为特征。行为问题在诊断时附近出现,且随时间趋于减轻,能力问题在系列评估中更具持续性,在LRE组和IGE组中均存在。