Understanding the enigma of neurobehavior in children with epilepsy and the need for mandatory screening: a prospective case control study

Background: In epilepsy management, control of seizures is the prime objective and reduction in seizure frequency is the main goal for successful treatment. There is a high prevalence of neurobehavioral problem. Hence, there is a need to screen, and intervene. Aim was to identify the neurobehavioral profile and the impact on children with epilepsy Methods: After IRB clearance, 100 consecutive school-aged children 4-17 years with normal IQ attending epilepsy clinic were enrolled as cases, and 102 age, gender and socio-economic status-matched children without epilepsy were chosen as controls. The strength and difficulties questionnaire are administered to both groups. It addresses five domains: emotional, conduct, hyperactivity, and peer problems which contribute to the total difficulties score, and fifth dimension prosocial behaviour. Results: Among the children with epilepsy, emotional issues were observed in 41%, conduct issues in 67%, hyperactivity behaviour in 54%, and peer problems in 64% while pro-social behaviour was only 27%, and total difficulty score was 60%, which was statistically significant with p<0.001 in all domains when compared to control. The impact of the disease was 73%, home environment was affected in 67%, classroom learning 45%, 28% in leisure activities, and 10% in friendship, which was statistically significant with p<0.001 in all domains when compared to control. Conclusions: We have identified emotional, conduct, hyperactivity and peer problems having significant impact on children with epilepsy. Hence a screening in various behavioural domains helps in early identification and prompt intervention of neurobehavior.