Abstracts

Rationale: CSE is associated with unfavourable outcomes especially in children with pre-existing neurological problems. Longer term behavioural outcomes of children post-CSE have not been rigorously investigated in an unselected population. The present study was designed to address this gap.Methods: We recruited children with a history of CSE originally identified by the population-based North London Convulsive Status Epilepticus in childhood surveillance study (NLSTEPSS) and normal controls. CSE participants were grouped according to the original aetiological classification in NLSTEPSS. The primary carer for each participant was asked to fill out: (a) the strengths and difficulties questionnaire (SDQ) (25 item checklist designed to look at emotional, peer, conduct, and hyperactivity problems as well as prosocial behaviour), (b) the Autism Spectrum Screening questionnaire (ASSQ) (27 item checklist designed to pick up autistic traits), and (c) the Swanson, Nolan, and Pelham questionnaire (SNAP) (18 item checklist designed to pick up attention deficit hyperactivity disorder traits). Children who had >15% of items in each scale non-applicable/missing were excluded from analysis. When <15% of items were missing, missing data points were replaced by the mean of the remaining items. Kruskal Wallis and Mann-Whitney tests were used for group comparisons. Spearman s correlations were used to investigate the relationships among the scales. All analyses were carried out in SPSS version 21.Results: Seventy-eight out of 134 (58.2%) children that were followed-up a mean of 7.98 years after their CSE episode provided questionnaire data (mean age: 11.38). Results were compared to those of 27 normal controls (mean age: 12.11). Aetiological groups were different in their scores on SDQ (p<0.001), ASSQ (p<0.001) and SNAP (p<0.001) (Figure 1). Total scores derived from the scales were positively correlated with each other (p<0.001). Compared to controls, children with PFS (N=27) had significantly higher SDQ scores (p=0.001) (see Figure 2 for the distribution of SDQ scores within the PFS group) and a trend for higher ASSQ scores (p=0.076). Their SNAP scores were not significantly different from controls (0.224). A comparison of the SDQ subscales between the groups revealed that the PFS group had higher scores than controls in the emotion (p=0.001), hyperactivity (p=0.012), and peer relationship (p=0.014) scales but not the conduct (p=0.115) or pro-social behaviour (p=0.172) scales.Conclusions: Children with a history of CSE have worse behavioural outcomes than age matched healthy controls. This applies even to children who had PFS and were neurologically normal prior to their PFS. The clinical significance of these findings warrants further discussion.