Children with epilepsy may have long-term problems far beyond seizures

A new federally-funded study published March 16 in the journal Pediatrics has concluded that children with epilepsy should be monitored closely for learning and social issues, regardless of whether their seizures are well controlled. The researchers found that children with epilepsy can develop social and educational issues whether or not they still experience seizures.

The researchers, from Children’s Hospital of Chicago, found that behavioral problems and learning difficulties during childhood can result in suboptimal educational and social outcomes among young adults. They found that learning disabilities such as ADHD and dyslexia and behavioral conditions such as anxiety, depression or bipolar disorder, can play a significant role in educational and social achievement. Identifying these problems early may help avoid problems faced by the child once they reach adulthood.

Previous research has shown that children with epilepsy tend to have worse social outcomes than healthy children, but this is the first study that looked at the role of seizure control related to learning and behavioral problems. The study found that often a child had seizures really did not play as big a role as previously thought.

Anne Berg Ph.D., lead author of the study, said, “Frequency and intensity of seizures remain important predictors of how well a child does into adulthood, but somewhat to our surprise we also found seizures are by no means the sole influencers of social and educational outcomes among adults with childhood epilepsy.” She also said that physicians who care for children with epilepsy should not conclude that everything is fine simply because seizures are controlled.

Berg encourages pediatricians to screen children with epilepsy for behavioral, psychiatric and learning problems. While the team cautions that the psychiatric conditions are usually not stemming from the epilepsy, but can be included with the behavioral and learning problems that are often associated with the disease.

For 12 years the researchers followed 241 children and teens who were diagnosed with uncomplicated epilepsy between 1993 and 1997. The children were treated at neurology practices in Connecticut. They tracked the education levels of participants, along with employment, marital status, ability to drive, living arrangements and criminal records as they moved into adulthood. The evaluated them compared to how many seizures they experienced after being diagnosed, and how effectively their seizures were controlled with medications.

How well the child’s seizures were controlled was a big factor in how likely they were to get a college degree and become successfully employed as an adult. However, this was not a guarantee of educational or social achievement. The researchers found that learning difficulties affected education without regard to seizure control. Emotional or psychiatric problems affected social outcomes.