Generalized epilepsy and febrile seizures plus (GEFS+) in a series of 22 patients

Abstract

Genetic epilepsies and their cognitive-behavioral traits have been described in various reviews. Nevertheless, it is difficult to find studies about generalized epilepsy and febrile seizures plus (GEFS+) displaying detailed descriptions of its neuropsychological comorbidities. We intend to describe the clinical picture of children with GEFS+, and its comorbidities, emphasizing cognitive-behavioral conditions, and also to find associations that may contribute to the development of these disorders. We reviewed clinical records from 22 patients diagnosed with GEFS+, based on clinical and family history (no genetic tests were conducted). Most of follow-up visits were with one of us (M. Devilat), over the period 1996–2011. Mean follow-up time was 5.3 yr (1–11 yr). Our investigation focused on the associated diagnoses: conduct disorder, attention deficit/hyperactivity disorder (ADHD), specific language impairment (SLI), specific learning disorders and intellectual disability (ID). Assessment for possible associations (i.e. age at onset, seizure-free period) was conducted. A total of 15 patients (68.18%) fulfilled the diagnostic criteria of these co-morbidities. The prevalence for each disorder was as follows: ADHD-six patients (27.27%); conduct disorder-five patients (22.73%); ID, SLI and specific learning disorders-four patients (18.18%) each. Among associated factors, long-lasting seizures and onset of seizures before 12 mo of life were statistically related to ID (P = 0.02 and P = 0.04, respectively). A normal electroencephalogram was predominant in patients with SLI (P = 0.01). We conclude that neuropsychological disorders are common among patients with GEFS+, ADHD being the most frequent diagnosis. Various factors including long-lasting epilepsy and early age of onset may be associated with cognitive disorders.