Children with epilepsy who experience behavioural issues are usually less affected with time, according to a new study.
The research, led by the Hospital for Sick Children in Toronto, aimed to examine the long-term prognosis of young people with epilepsy who experience behavioural difficulties, specifically looking at the differences between those treated with or without surgery.
It is established that around 50% of children with drug-resistant (intractable) epilepsy are affected by behavioural problems of some kind, but to date there has been little research into these individuals’ long-term outcome after undergoing epilepsy surgery.
A total of 108 patients with childhood-onset intractable epilepsy were involved in the study, of whom 71 underwent surgery (the surgical group) and 37 did not (the non-surgical group). A standardised behavioural checklist was used to assess the surgery patients prior to their operations and again four to 11 years later, and the non-surgical group underwent the same tests at comparable time points.
The results, published in the Journal of Neurology, showed that both groups became less prone over time to both ‘externalising’ behaviours such as violent or aggressive outbursts and behaviours such as thought problems and attention difficulties.
There was no significant difference between the surgical and non-surgical groups in any of the criteria assessed, but it was found that patients who achieved seizure freedom tended to have fewer symptoms in almost all behavioural domains. Meanwhile, those with greater behaviour problems at baseline were shown to be more likely to experience improvements.
The researchers concluded: “The described long-term outcomes of behaviour problems among patients with childhood-onset intractable epilepsy are encouraging, in that modest improvements were noted among all patient groups. Furthermore, seizure freedom, whether achieved through surgery or medication management, was associated with fewer behavioural problems in most domains.”
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