Abstracts

In previous studies we have found that children with prior unrecognized seizures (PURS) have more behavioral problems than their siblings or children with true new-onset seizures. If behavioral problems are due to subclinical seizures or the effects of epileptiform discharges, then treatment with antiepileptic drugs (AEDs) might be associated with improvement in behavior. The purpose of this study is to determine if change in behavior over time is different for children with PURS that are treated by AEDs compared to 3 other groups: children with PURS not treated with AEDs, children with new-onset treated with AEDs, and children with new-onset seizures not treated with AEDs., The children, ages 6-14 years, were part of a study of new onset seizures. Seizure history was obtained from parents and chart review. The history from the parents was used to determine the presence of PURS or true new-onset seizures. Behavior was assessed at baseline and 18 months using the Child Behavior Checklist (CBCL) and the CBCL Teacher Report Form (TRF). There were 77 children with PURS that received AEDs and 16 with PURS that were not treated with AEDs. One hundred thirteen children had no prior seizures and received AEDs and 62 had no prior seizures and no AEDs., Scores on both CBCL and TRF were higher (more problems) at baseline in children with PURS. Improvement over 18 months was found in total and internalizing behaviors and to a lesser extent, externalizing behavior, in all groups. There were no differences by group in change in behavior. As a sub-analysis, we also looked at seizure recurrence after the first recognized seizure in those children with PURS treated with AEDs (n=77). After controlling for behavior at baseline, there was no difference in change in groups with or without seizure recurrence., Children with PURS had worse behavior than children without PURS both at baseline and 18 months. In addition, although behavior improved over time for all four groups, the improvement was not greater in the children with PURS treated with AEDs compared to the other three groups., (Supported by NINDS: PHS R01 NS22416 (PI-J.Austin).)