Abstracts

RATIONALE: Epilepsy affects many aspects of a child s life. Identification of which aspects of epilepsy have the greatest impact is a necessary step in providing appropriate interventions to patients and counseling to families. METHODS:As part of a prospective community-based study of 613 children with newly diagnosed epilepsy, the screening version of the Vineland Adaptive Behavior Scales was administered to children who were <4y at the time of onset of epilepsy and then again two years after diagnosis. The composite baseline score and the difference between two-year and baseline scores were the main outcomes. Social, communication, motor, and daily living domain scores were also studied. Scores are normed to a mean of 100, std=15 Analyses were performed with t-tests and multiple linear regression. RESULTS: Of 229 eligible for the analysis, 165 had both Vinelands completed. Composite scores dropped an average of 8.2 points from study entry to two years. Half had a >10 point drop. In a multiple regression model, only symptomatic etiology was significantly associated with lower baseline composite scores (-19.1, p=0.001). After two years, factors associated with a significant decrease from baseline composite scores were: non-idiopathic generalized syndrome (-8.2, p=0.04), symptomatic etiology (-8.2, p=0.05), <1 year at onset of epilepsy (-8.6, p=0.01), and development of intractable epilepsy (-20.7, p=0.0001). Children who had none of these factors had no significant change in mean scores, -0.63 (95% CI -4.1, 5.4). Similar patterns were seen for individual domain scores. CONCLUSIONS: Young children with epilepsy experience significant and substantial declines in adaptive function following the diagnosis of epilepsy. Most factors associated with declines in scores are not associated with scores at initial diagnosis. This suggests that the declines are in response to the underlying disease process and possibly the result of refractory seizures. NINDS R01 NS-31146