Effect of antiepileptic drugs on behavioural and school underachievement in newly diagnosed idiopathic generalized childhood epilepsy

Abstract

Children with epilepsy are known to be prone to educational underachievement as a result of learning and behavioural problems. Identification of these comorbidities and their early intervention will go a long way in improving quality of life of children with epilepsy. The objective of this paper is to study the incidence of behavioural disorders (BD) and school underachievement (SU) in newly diagnosed generalized idiopathic epileptic children, and to determine association of behavioural disorders and school underachievement with different antiepileptic drugs. The design is prospective observational cohort study. Settings and duration is private multidisciplinary neuropaediatric clinics, from 1st September 2010 to 31st August 2013. 305 school going (7 to 16 years) children, 205 children with newly diagnosed idiopathic generalized epilepsy (study group) and 100 non-epileptic peers (50 siblings of epileptic children and 50 healthy children without family history of seizures or other chronic neurological illness (control group) were evaluated for BD and SU for over a period of four years. Chi Square Test was used for statistical analysis. The prevalence of BD and SU were present simultaneously in most of the patients. BD and SU were 11% in the study group, 10% in siblings of epileptic children, while in the control group without family history of epilepsy was 6% and this was statistically significant (p < 0.05). All epileptic children and their siblings have higher incidence of BD and SU as compared to their normal counterparts. These are associated with all currently used antiepileptic drugs (AEDs) in children. A holistic approach, comprising medical, educational and psychosocial counselling of families and placement of the child both in society and school should form integral part of management of idiopathic generalized childhood epilepsy (IGCE).

Keywords: Antiepileptic drugs, cognition, epilepsy, medication, neuropsychology, behavioural disorders, school underachievement.