Abstract
Studies of generalized electroclinical syndromes can provide guidance regarding long-term seizure, cognitive, and psychosocial outcomes. Childhood absence epilepsy, juvenile absence epilepsy, juvenile myoclonic epilepsy, and idiopathic generalized epilepsy with generalized tonic-clonic seizures alone are electroclinical syndromes typically associated with normal intellect and good response to antiseizure medications. However, studies have demonstrated significantly poorer psychosocial outcomes than expected for these syndromes, regardless of seizure control. Potential causes for this include underlying abnormalities in social skills, social stigma, and underlying abnormalities in brain development and maturation.
Highlights
When Caplan et al [5] compared children with Childhood absence epilepsy (CAE) who had intelligence quotients (IQ) of 70 or higher to normal children, they found those with CAE had significantly lower IQ across all subcategories
Those with CAE were more likely to have attention deficit hyperactivity disorder (ADHD) (26% vs 6%) and anxiety (20% vs 7%), and this was correlated with longer duration of illness and higher seizure frequency
Long-term studies of cohorts of adolescents with Juvenile myoclonic epilepsy (JME) have demonstrated that approximately one-fourth of those who become seizure free are able to remain seizure free off anti-seizure medications (AEDs) [12,13,14]
Summary
Seizure and Psychosocial Outcomes of Childhood and Juvenile Onset Generalized Epilepsies: Wolf in Sheep’s Clothing, or Well-Dressed Wolf?. Wirrell et al [1] compared the long-term psychosocial outcome of patients with childhood or juvenile absence epilepsy to that of children and adolescents with juvenile rheumatoid arthritis (JRA) Those with a history of absence seizures were more likely to require special education, have below-average academic performance, and behavior problems. Long-term studies of cohorts of adolescents with JME have demonstrated that approximately one-fourth of those who become seizure free are able to remain seizure free off AEDs [12,13,14] Those with longer duration of epilepsy and continued seizures before achieving seizure freedom, requiring AED polytherapy to become seizure free, or absence seizures at diagnosis were less likely to achieve seizure remission [13, 14]. This suggests the epilepsy and depression/ anxiety may originate from a common pathology
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