Childhood Epilepsy Is Tied To Psychiatric Disorders

BOSTON — Children with benign focal epilepsy with centro-temporal spikes had a higher incidence of psychiatric illnesses, attention-deficit/hyperactivity disorder (ADHD), and developmental delay compared with the estimated incidence in the general population, based on a retrospective study of electroencephalogram findings.

Children with benign focal epilepsy “are not sufficiently screened for psychological and other cognitive problems. The nocturnal seizures are often missed, unless the child generalizes; and most institutions don't have a good neuropsychiatry division to assess for learning difficulties. Subtle learning difficulties often go undetected,” Dr. Shalaka Indulkar reported in a poster presentation at the annual meeting of the American Epilepsy Society.

Dr. Indulkar and colleagues reviewed consecutive routine EEGs from 1995 through 2004 for pediatric patients with benign focal epileptiform discharges. They identified 117 whose seizures were consistent with benign focal epilepsy with centro-temporal spikes (BECTS). These features included either typical brief hemifacial seizures associated with speech arrest, drooling, and preservation of consciousness; gurgling or grunting noises with loss of consciousness and terminating in vomiting; or nocturnal secondarily generalized seizures.

Data also included general demographics and neurologic, behavioral, and psychiatric disorders and used descriptive data and the Fisher's exact test for analysis.

Of the 117 patients in the analysis, 51 were girls and 66 were boys. Mean age at initial diagnosis of EEG abnormality was 6.8 years, said Dr. Indulkar, a neurology resident at Cleveland Clinic.

The prevalence of co-existing psychiatric problems, including anxiety, schizophrenia, obsessive compulsive disorder, and depression in the study population was 9.4%, she reported, noting that this rate is substantially higher than the estimated 1%–4% seen in the general pediatric population.

ADHD was observed in 11% of the seizure population, compared with an estimated prevalence rate of 3%–7% in school-aged children in the United States. In addition, developmental delay, including pervasive developmental disorder, language disorder, and autism, was found in 10.2% of the seizure population, and tics were noted in 5.1%. “We also found a high incidence of children with migraine and headaches in the study population,” Dr. Indulkar said.

In an interview, she said that “children with typical [BECTS] do not necessarily have abnormal EEGs in sleep, but they still may have learning difficulties, so the mechanism [for the CNS-related comorbidities] remains elusive.”

Dr. Indulkar reported no relevant disclosures and said no specific funding was used to conduct the study.

BOSTON — Children with benign focal epilepsy with centro-temporal spikes had a higher incidence of psychiatric illnesses, attention-deficit/hyperactivity disorder (ADHD), and developmental delay compared with the estimated incidence in the general population, based on a retrospective study of electroencephalogram findings.

Children with benign focal epilepsy “are not sufficiently screened for psychological and other cognitive problems. The nocturnal seizures are often missed, unless the child generalizes; and most institutions don't have a good neuropsychiatry division to assess for learning difficulties. Subtle learning difficulties often go undetected,” Dr. Shalaka Indulkar reported in a poster presentation at the annual meeting of the American Epilepsy Society.

Dr. Indulkar and colleagues reviewed consecutive routine EEGs from 1995 through 2004 for pediatric patients with benign focal epileptiform discharges. They identified 117 whose seizures were consistent with benign focal epilepsy with centro-temporal spikes (BECTS). These features included either typical brief hemifacial seizures associated with speech arrest, drooling, and preservation of consciousness; gurgling or grunting noises with loss of consciousness and terminating in vomiting; or nocturnal secondarily generalized seizures.

Data also included general demographics and neurologic, behavioral, and psychiatric disorders and used descriptive data and the Fisher's exact test for analysis.

Of the 117 patients in the analysis, 51 were girls and 66 were boys. Mean age at initial diagnosis of EEG abnormality was 6.8 years, said Dr. Indulkar, a neurology resident at Cleveland Clinic.

The prevalence of co-existing psychiatric problems, including anxiety, schizophrenia, obsessive compulsive disorder, and depression in the study population was 9.4%, she reported, noting that this rate is substantially higher than the estimated 1%–4% seen in the general pediatric population.

ADHD was observed in 11% of the seizure population, compared with an estimated prevalence rate of 3%–7% in school-aged children in the United States. In addition, developmental delay, including pervasive developmental disorder, language disorder, and autism, was found in 10.2% of the seizure population, and tics were noted in 5.1%. “We also found a high incidence of children with migraine and headaches in the study population,” Dr. Indulkar said.

In an interview, she said that “children with typical [BECTS] do not necessarily have abnormal EEGs in sleep, but they still may have learning difficulties, so the mechanism [for the CNS-related comorbidities] remains elusive.”

Dr. Indulkar reported no relevant disclosures and said no specific funding was used to conduct the study.

BOSTON — Children with benign focal epilepsy with centro-temporal spikes had a higher incidence of psychiatric illnesses, attention-deficit/hyperactivity disorder (ADHD), and developmental delay compared with the estimated incidence in the general population, based on a retrospective study of electroencephalogram findings.

Children with benign focal epilepsy “are not sufficiently screened for psychological and other cognitive problems. The nocturnal seizures are often missed, unless the child generalizes; and most institutions don't have a good neuropsychiatry division to assess for learning difficulties. Subtle learning difficulties often go undetected,” Dr. Shalaka Indulkar reported in a poster presentation at the annual meeting of the American Epilepsy Society.

Dr. Indulkar and colleagues reviewed consecutive routine EEGs from 1995 through 2004 for pediatric patients with benign focal epileptiform discharges. They identified 117 whose seizures were consistent with benign focal epilepsy with centro-temporal spikes (BECTS). These features included either typical brief hemifacial seizures associated with speech arrest, drooling, and preservation of consciousness; gurgling or grunting noises with loss of consciousness and terminating in vomiting; or nocturnal secondarily generalized seizures.

Data also included general demographics and neurologic, behavioral, and psychiatric disorders and used descriptive data and the Fisher's exact test for analysis.

Of the 117 patients in the analysis, 51 were girls and 66 were boys. Mean age at initial diagnosis of EEG abnormality was 6.8 years, said Dr. Indulkar, a neurology resident at Cleveland Clinic.

The prevalence of co-existing psychiatric problems, including anxiety, schizophrenia, obsessive compulsive disorder, and depression in the study population was 9.4%, she reported, noting that this rate is substantially higher than the estimated 1%–4% seen in the general pediatric population.

ADHD was observed in 11% of the seizure population, compared with an estimated prevalence rate of 3%–7% in school-aged children in the United States. In addition, developmental delay, including pervasive developmental disorder, language disorder, and autism, was found in 10.2% of the seizure population, and tics were noted in 5.1%. “We also found a high incidence of children with migraine and headaches in the study population,” Dr. Indulkar said.

In an interview, she said that “children with typical [BECTS] do not necessarily have abnormal EEGs in sleep, but they still may have learning difficulties, so the mechanism [for the CNS-related comorbidities] remains elusive.”

Dr. Indulkar reported no relevant disclosures and said no specific funding was used to conduct the study.