Shanmuganathan Harshitha, Kumar Radha, Lal D V, Gulab Chaudhary Devanand, Gayathri E, Raja Kesavaraj Pallavi
M.B.B.S, M.D. Paediatrics, Fellow in Developmental Paediatrics, Department of Pediatrics, Saveetha medical college and hospital, Thandalam, Kancheepuram, Tamilnadu, 602105, India.
M.B.B.S, M.D. Paediatrics, Professor, Department of Pediatrics, Saveetha medical college and hospital, Thandalam, Kancheepuram, Tamilnadu, 602105, India.
AIMS Neurosci. 2022 Jun 1;9(2):277-287. doi: 10.3934/Neuroscience.2022015. eCollection 2022.
Children with epilepsy are at greater risk of developing psychiatric and behavioural disorders such as attention deficit/hyperactivity disorder (ADHD), conduct disorder, autism spectrum disorder (ASD), as well as affective and aggressive disorders than normal children which may affect the well- being and quality of life of the child.
This study aims at identifying behavioural problems in children with epilepsy enabling early diagnosis and intervention. The objectives were to assess the presence and type of behavioural problems in children with epilepsy.
A prospective cross-sectional study was conducted on children who were diagnosed as epilepsy in two age groups of 1.5-5 years and 6-18 years recruited by non-probability convenience sampling. Data regarding seizure semiology, clinical features and treatment were obtained. Children underwent IQ assessment, electroencephalogram and brain neuroimaging. Child Behaviour Check List (CBCL) was administered to parents or primary caregivers after obtaining informed consent. Results were analyzed for presence of behavioural problems using SPSS-23.
In the study, out of 50 study subjects, 72% were between 6-18 years. 60% children had generalised seizures, 58% children had epilepsy for <2 years and abnormal EEG was present in 80% children. 6% children had behavioural problems and 4% had borderline presentations. Co-relation of behavioural problems with age was statistically significant with p value 0.027. Behavioural problems identified were aggressiveness and anxiety.
Childhood epilepsy is associated with behavioural problems along with other co-morbidities warranting a search during follow-up visits.
TAKE-HOME MESSAGE: Early identification and treatment of behavioural problems in children with epilepsy by periodic assessment during follow up visits, careful selection of combination of drugs and appropriate dose can improve the overall outcome in children taking antiepileptic drugs (AEDs) for epilepsy.
与正常儿童相比，癫痫患儿患精神和行为障碍的风险更高，如注意力缺陷/多动障碍（ADHD）、品行障碍、自闭症谱系障碍（ASD）以及情感和攻击障碍，这些可能会影响患儿的幸福感和生活质量。
本研究旨在识别癫痫患儿的行为问题，以便早期诊断和干预。目标是评估癫痫患儿行为问题的存在情况和类型。
采用非概率方便抽样法，对1.5至5岁和6至18岁两个年龄组被诊断为癫痫的儿童进行前瞻性横断面研究。获取有关发作症状学、临床特征和治疗的数据。患儿接受智商评估、脑电图和脑影像学检查。在获得知情同意后，向家长或主要照顾者发放儿童行为检查表（CBCL）。使用SPSS-23分析结果以确定行为问题的存在情况。
在该研究中，50名研究对象中，72%年龄在6至18岁之间。60%的患儿有全身性发作，58%的患儿患癫痫时间小于2年，80%的患儿脑电图异常。6%的患儿有行为问题，4%有临界表现。行为问题与年龄的相关性具有统计学意义，p值为0.027。识别出的行为问题为攻击性和焦虑。
儿童癫痫与行为问题以及其他合并症相关，在随访期间需要进行筛查。
通过随访期间的定期评估、谨慎选择药物组合和适当剂量，早期识别和治疗癫痫患儿的行为问题，可以改善服用抗癫痫药物（AEDs）治疗癫痫的患儿的总体预后。
