Neuropsychological and behavioral disorders screening program in new-onset childhood epilepsies. Preliminary results using child behavior checklist evaluation

Abstract

Objective: Cognitive impairments and emotional dysregulations are frequently encountered in children with all types of epilepsy. Retrospective studies highlight these difficulties but fail to determine their chronology of appearance which might be influenced by many factors (syndrome, seizure frequency, treatment…). Early detection of pre-existing or progressively developing deficits represent real challenges for global epilepsy-care programs. Methods: We developed a comprehensive approach for an early detection of behavioral and cognitive deficits in newly diagnosed epilepsies. During the first visit, children were received in a day hospital for a global evaluation including a sleep and awake EEG, somatic and neurological examination, an epilepsy nurse interview and a preliminary evaluation of behavior and social competences using the Child Behavior Checklist (CBCL, Achenbach, 1991). A first neuropsychological screening was conducted to assess attention abilities and executive functions using EpiTrack Junior (Helmstaedter, 2013). Depending on the results, a full neuropsychological evaluation can be scheduled. At the follow-up outpatient clinics, an epilepsy nurse interviewed the patient and his family using questionnaires on AEDs side effects and on “living with epilepsy”. A re-test with EpiTrack Junior is performed. Results: Preliminary results of the CBCL evaluation for idiopathic epilepsies (IE) – 36 children without epilepsy (NE); 37 children with IE (11 under AED treatment) – showed that at maximum 6 months from epilepsy onset, even benign forms of epilepsy score lower than NE in the Competences scale, assessing scholar, extrascholar and social skills (t(71)=2,01, p<.05), especially when under AEDs (t(45)=2,53, p<.02). Externalization scale showed that IE have more aggressive and delinquent behaviors as compared to NE (t(71)=2,16, p<.03) especially when under treatment (t(45)=2,55, p<.01). Conclusion: Our results underscore the need for an early multidisciplinary approach and detection of neuropsychological or behavioral deficits to engage appropriate reeducations.