Till startsida
University of Gothenburg
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Cognitive and behavioral problems in symptomatic and non-symptomatic childhood epilepsy

Participants: Takatoshi Hosokawa, Naomi Mitsuda, Yuji Izumoto, Yuhei Hatakenaka, Elizabeth Fernell & Christopher Gillberg.

Background: It is reported that epilepsy and developmental disorders tend to coexist with each other at a high rate. Many patients with epilepsy present with hyperactivity, inattention, communication problems, and low academic achievement. These problems may be caused by intellectual disability and other developmental disorders, and may partially relate to epileptic seizures and side effects of antiepileptic drugs. We wondered whether such symptoms in epilepsy patients are specific to the epilepsy condition or relate more specifically to the intellectual disability.

Methods: In this study, 43 individuals, aged 2 - 24 years at the time of the study, with a clinical diagnosis of epilepsy, were included. They were subdivided into idiopathic or symptomatic groups. EEG, imaging studies, and intelligence quotients were checked. They were also assessed regarding neurodevelopmental diagnoses based on DSM-IV-TR. The following questionnaires for developmental disorders were used; Autism-Spectrum Quotient (AQ), Autism Screening Questionnaire (ASQ), The high-functioning Autism Spectrum Screening Questionnaire (ASSQ), Pervasive Developmental Disorders autism Society Japan Rating Scale (PARS), ADHD Rating Scale (ADHD-RS), and the Strength and Difficulties Questionnaires (SDQ).

Results: All of the patients with idiopathic epilepsy had IQs in the normal range, while in the symptomatic epilepsy group there were 13/23 who had intellectual development disorder (IDD) and 7/23 with borderline intelligence. Five of the 43 had been given an autism spectrum disorder diagnosis (ASD) with no IDD, with no difference across the two epilepsy subgroups. Curiously, none of the children with epilepsy and IDD had been given an ASD diagnosis. No patient in the whole group had been assigned an ADHD diagnosis. The symptomatic epilepsy group scored higher than the idiopathic group on ASSQ, ASQ, PARS, ADHD-RS, and SDQ. As there was a great difference in IQ between the two groups, we postulated that this IQ difference accounted for the differences in these questionnaires results. However, there was no significant correlation between IQ and questionnaires results. Inattention/hyperactivity was extremely common according to the questionnaires, in the face of no ADHD diagnosis having been clinically assigned.

Conclusion: The results would seem to indicate that IDD is almost universal in symptomatic epilepsy, but is rare in idiopathic cases of epilepsy. The clinical diagnosis of ADHD is very rarely made in epilepsy even in the presence of typical symptoms of the disorder. ASD and ADHD are probably underdiagnosed clinically in young Japanese people with epilepsy.

 

Page Manager: Anna Spyrou|Last update: 1/13/2013
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