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Neuropediatrics 2020; 51(02): 164-169
DOI: 10.1055/s-0039-3399529
Short Communication
Georg Thieme Verlag KG Stuttgart · New York

Early Onset, Long Illness Duration, Epilepsy Type, and Polypharmacy Have an Adverse Effect on Psychosocial Outcome in Children with Epilepsy

Valeria Valova
1   Charité – Universitätsmedizin Berlin, Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Berlin, Germany
2   Charité – Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany
,
Aleksandra Kochan
1   Charité – Universitätsmedizin Berlin, Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Berlin, Germany
2   Charité – Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany
,
Bianca Werry
1   Charité – Universitätsmedizin Berlin, Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Berlin, Germany
2   Charité – Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany
,
Rainer John
1   Charité – Universitätsmedizin Berlin, Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Berlin, Germany
2   Charité – Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany
,
Christine Prager
1   Charité – Universitätsmedizin Berlin, Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Berlin, Germany
2   Charité – Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany
,
Joanna Schneider‡   *
1   Charité – Universitätsmedizin Berlin, Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Berlin, Germany
2   Charité – Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany
4   Berlin Institute of Health, Berlin, Germany
,
Angela M. Kaindl   *
1   Charité – Universitätsmedizin Berlin, Center for Chronically Sick Children (Sozialpädiatrisches Zentrum, SPZ), Berlin, Germany
2   Charité – Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany
3   Charité – Universitätsmedizin Berlin, Institute of Cell- and Neurobiology, Berlin, Germany
› Author Affiliations Acknowledgment The authors thank the patients and their parents. The study was funded by the German Research Foundation (DFG, SFB1315, FOR3004) and the Charité - Universitätsmedizin Berlin.
Further Information

Publication History

07 December 2018

29 September 2019

Publication Date:
21 November 2019 (online)

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Abstract

Epilepsy is often associated with psychosocial comorbidity and this can be more disabling than the seizure activity. Still, these associated conditions are often underdiagnosed and therefore not sufficiently treated. We studied a large pediatric cohort of 371 patients with epilepsy to identify factors associated with negative outcome. We found that patients with early-onset epilepsy, epilepsy of known etiology, and polypharmacy were the most likely to display cognitive impairment. Behavioral problems were particularly prevalent in patients with an epilepsy duration ≥ 5 years. Similarly, early-onset epilepsy, long illness duration, epilepsy of known etiology, and polypharmacy had an adverse effect on school placement and/or social contact. With polypharmacy being the only potentially modifiable factor, it is important to balance between benefits and adverse effects of antiepileptic drugs and consider alternative therapy options in selected patients such as epilepsy surgery, vagal nerve stimulation, and ketogenic diet early-on.

Keywords

pediatric epilepsy - antiepileptic drugs - comorbidity - psychosocial

Competing Interests

The authors declare that they have no competing interests.


Authors' Contributions

AMK and JS were responsible for the project conception. VV, JS, and AMK wrote the manuscript. VV, AK, and BW collected patient data and incorporated them into a database. VV and JS analyzed the data. All authors read, revised, and approved the final manuscript.


* Equal contribution.