Children's Behaviour & Future SeizuresA large-scale study of behaviour in children with newly recognized seizures, reported in the January 2001 issue of the journal
Pediatrics shows that more children than was expected experience disruptions in attention, thought and behaviour during the 6 months before parents and caregivers begin to notice seizures. This brings into question the prevailing view that adjustment problems develop after a child begins to experience seizures, as a reaction to them and/or their treatment.
Joan Austin (professor at Indiana University School of Nursing, member of the Epilepsy Foundation Professional Advisory Board, and co-author of the study) postulates that epilepsy and behaviour may be linked as part of a syndrome: whatever may be causing seizures in some children may also be causing their behavioural problems. Currently, many people believe that behavioural problems in children with epilepsy may result from poor adjustment to the condition, the stigma associated with the condition, societal attitutes, or the side effects of medications. Also, some children might feel distressed when they [intuitively] know that something is wrong with them but no one acknowleges it.
The study shows that 32.1% of children are already at risk for a variety of behavioural problems at the time of their first recognized seizure. The risk is even greater (39.5%) in children who may have had seizures which remained unrecognized for some time before diagnosis. In the study, parents were asked to use a checklist to identify changes in behaviour during the 6 months prior to seizure recognition. Teachers of these children also rated the children's behaviours and reported similar results. Parents and teachers also rated children for aggression, anxiety/depression, delinquency, social problems, and withdrawal. Children with epilepsy showed greatest problems in areas of attention, thought and general complaints (headache and upset stomach).
The study also shows that some siblings of children with seizure disorders have higher-than-normal behavioural problems. This might be due to higher ratings assigned by parents (reflecting their stress) or the possible negative impact of the affected child's behaviour on the family. Further research is needed to determine whether siblings are also at risk for behavioural problems requiring attention.
The authors emphasize the importance of identifying and addressing these problems early, to try to reduce or prevent difficulties commonly experienced by children with epilepsy in school and at home.
The study acknowleges that it was already known before this study that behavior problems often exist in children with chronic epilepsy. This study aimed to identify the point in time when behavioural problems might become apparent in children with new onset epilepsy. This is important because quality of life issues can be more disabling than seizures themselves and must be addressed early in treatment.
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