Abstracts

Rationale: The poor social, vocational, and psychiatric outcome findings (Olsson & Campehausen, 1993; Wirrell et al., 1997) of this “seemingly benign” epilepsy syndrome suggest long-term unmet mental health, social, and vocational needs in these patients. Evidence during childhood for impaired attention, memory (Henkin et al. 2005; Pavone et al., 2000; Mandelbaum & Burack, 1997), language (Henkin et al., 20059; Caplan et al. 2001, 2002 ), and behavior (Caplan et al., 1998; Ott et al., 2001; Mandelbaum & Burack,, 1997) in this seizure disorder underscores the need to identify CAE patients at risk for these problems. This study examined if, compared to normal children, children with CAE have predominantly attention deficit disorder as well as the attention, thinking, and social problems found in other children with epilepsy (Rodenburg et al. 2005). Within the CAE group, it investigated variables associated with the behavioral, cognitive and linguistic comorbidities.Methods: 80 children with CAE, aged 9.4 (2.76) years and 133 age and gender matched normal children underwent structured psychiatric interviews, as well as cognitive and linguistic testing. Parents provided behavioral information on the child through a psychiatric interview and the Child Behavior Checklist (CBCL), as well as demographic and seizure-related information.Results: Despite mean average IQ and SLQ scores, 20%-40% of the CAE children had subtle cognitive and linguistic difficulties, 57% had psychiatric diagnoses, particularly ADD (29%) and anxiety disorder diagnoses (22.5%), and 26%-35% had CBCL clinically relevant broad band scores. These rates were significantly higher than in the normal group (p<.02-<.0001). The most commonly found narrow band factor scores in the clinical/borderline range were somatic complaints (33%) and social problems (20%) followed by thought (18.7%) and attention problems (14.7%). Duration of CAE, seizure frequency, and treatment with antiepileptic drugs predicted the psychopathology, cognitive, and linguistic comorbidities. Whereas ADD diagnoses were predicted by lower Full Scale IQ, longer duration, and increased seizure frequency, the presence of anxiety disorder diagnoses were significantly associated with longer duration, increased seizure frequency, and clinically relevant somatic complaint scores. Conclusions: These findings suggest that CAE impacts the development of attention, emotions, cognition, and language, particularly in children with on-going absence seizures, longer duration, and antiepileptic drug treatment. Although cross-sectional, childhood onset of untreated behavioral, cognitive, and linguistic comorbidities might underlie the long-term poor social, vocational, and psychiatric outcome of CAE. (Funding supported by NS32070)