Art therapy focus groups for children and adolescents with epilepsy

Children with epilepsy are at risk for numerous psychological and social challenges. We hypothesized that art therapy focus groups would enhance the self-image of children and adolescents with epilepsy. Sixteen children with epilepsy, ages 7-18 years, were recruited from pediatric neurology clinics at the University of Wisconsin to participate in four art therapy sessions. Pre-group assessments included psychological screens (Piers-Harris Children's Self-Concept Scale; Childhood Attitude Toward Illness Scale; Impact of Childhood Neurologic Disability Scale) and art therapy instruments (Formal Elements Art Therapy Scale; Seizure Drawing Task; Levick Emotional and Cognitive Art Therapy Assessment). Developmental levels of drawings were significantly below age-expected standards. Following completion of focus groups, a repeat Childhood Attitude Toward Illness Scale showed no differences between pre- and post-test scores on any measure of this scale. However, subjects and parents were uniformly positive about their group experiences, suggesting a qualitative benefit from participation in art therapy focus groups.     

A karate program for improving self-concept and quality of life in childhood epilepsy: results of a pilot study

The potential cognitive and psychosocial effects of childhood epilepsy have significant implications for a child's self-image and academic achievement. This study focuses on a 10-week karate program for children and adolescents with epilepsy aimed at increasing social confidence, self-concept, and quality of life, as well as reducing parental anxiety. Eleven children (8-16 years old) and their parents participated in this questionnaire study, and complete data were available for nine of these families. Measures consisted of the Piers-Harris Children's Self-Concept Scale, the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire, and the Parental Stress Index. By parental report, significant improvement in memory function and largely positive trends in quality of life on multiple subscales were observed. By child report, intellectual self-esteem and social confidence also improved. Parental stress decreased, although not significantly, suggesting a potential benefit and indicating a role for future interventions targeting family anxiety.     

Beyond medical diagnosis: Factors contributing to life satisfaction of women with epilepsy in Israel

This study was an exploratory study aimed to examine the contribution of both objective variables (such as education, occupational status, and leisure activity) and subjective variables (such as perceived disability, body image, and feminine self-image) to the life satisfaction of women with epilepsy in Israel. The study also sought to compare the findings with earlier studies of women with epilepsy or other disabilities in order to identify similar patterns in their life satisfaction. The study included 70 women, who had applied in the past to the Israel Epilepsy Association to obtain information and leisure activities. They were asked about their degree of life satisfaction in the context of their personal data including occupational status, leisure activity, perceived disability, body image, and feminine self-image. Findings indicated that higher education and perception of body image and femininity were positively correlated with higher life satisfaction. The regression model showed that perceived severity of disability and body image had the highest contribution to satisfaction with life, a fact that attests to the paramount importance of women's perception of their health disability in dealing with the disorder. These findings are discussed in relation to earlier comparative studies of those with/without epilepsy. The implications for practice suggest aspects that ought to be included in therapeutic interventions such as including contents related to feminine self-image and body image in the rehabilitation process as well as recommendations for future studies.     

Epilepsy surgery in children: no further threat to theory of mind

Aims. To investigate whether theory of mind (ToM), an important requirement for adaptive social functioning, is different between children with pharmacologically refractory epilepsy who undergo epilepsy surgery and healthy control children, whether ToM is affected by epilepsy surgery in these children, and whether ToM is associated with demographic or epilepsy variables. Methods. The “ToM storybooks”, a psychometrically sound ToM instrument designed for children, was administered shortly before and 0.5, one and two years after surgery as part of a neuropsychological assessment. Fifteen patients (mean age: 7.1 years) completed the ToM storybooks before and at least twice after surgery. Two sex‐ and age‐matched healthy control children were included per patient. Linear mixed models were used to analyse differences between patients and controls. The association between ToM and demographic, epilepsy and surgical variables was explored. Results. Patients had lower ToM scores than healthy control children, even when corrected for verbal intelligence quotient (VIQ). Epilepsy surgery had neither a harmful nor a favourable effect on ToM. Later epilepsy onset and temporal origin of epilepsy were associated with higher (better) ToM scores relative to earlier epilepsy onset and extra‐temporal epilepsy (including hemispherotomy in one case). Children in whom the amygdala was resected had worse ToM scores. Conclusion. Children with refractory epilepsy have a ToM deficit that may not be accounted for by lower VIQ. Epilepsy surgery does not affect ToM functioning. Younger age at epilepsy onset is associated with poorer ToM, and temporal epilepsy with better ToM. Finally, the amygdala is implicated in ToM deficit. Patients and their parents should be educated about the possible consequences of epilepsy with regards to the development of social cognition and should be guided in order to help improve ToM.     

Self-assessment of well-being in a group of children with epilepsy.

Epilepsy is common in childhood, the prevalence being about five per 1000 children. The purpose of this study was to assess well-being in children with controlled epilepsy (but did not include those with obvious neurodeficits such as mental retardation or cerebral palsy) and compare them with age-matched healthy children. The patient group comprised of 31 children, 12 boys and 19 girls, whereas the control population group consisted of 342 children, 176 boys and 166 girls who were all in good health. All children involved in the study were aged between 9-13 years. A questionnaire was distributed to the children to complete. It consisted of 39 bipolar adjectives and a visual analogue scale was employed. The results show that the group of children with controlled epilepsy did not differ significantly from the age-matched control group. There was no significant difference between the sexes except for the dimension of vitality, where the boys scored better than the girls. Thus the well-being of children with controlled epilepsy seems to be similar to that of children from a control population. The psychometric properties of the instrument were also assessed. An assessment of well-being in children with intractable epilepsy, using a similar approach, is in progress.     

KCNJ10基因rs1890532单核苷酸多态性与儿童癫痫易感性的相关性研究

目的探讨中国北方汉族儿童中KCNJ10基因rs1890532单核苷酸多态性与癫痫的关系。方法 212例癫痫患儿作为病例组,按照癫痫发作类型分为部分性发作(partial Seizures,PS)组120例和全面性发作(generalized seizures,GS)组和92例,同时选择200例非癫痫儿童作为对照组,收集一般临床资料,采用聚合酶链反应-限制性片段多态性法检测KCNJ10基因rs1890532单核苷酸多态性,分析其与癫痫易感性的关系。结果校正年龄、性别等混杂因素后,KCNJ10基因rs1890532位点单核苷酸多态性与儿童GS在等位基因模型(C/G)和隐性基因模型[(CC+CG)/GG)]下整体效应具有统计学意义(OR=1.325,95%CI:1.014~2.461,P=0.043;OR=3.173,95%CI:1.097~10.694,P=0.021)。对照组与病例组、PS组比较,等位基因和基因型频率差异均无统计学意义(均P0.05)。结论 KCNJ10基因rs1890532单核苷酸多态性可能与儿童GS遗传易感性相关。     

Behavioral Disorders in Japanese Epileptic Children

Abstract: Psychiatric problems have been discussed concerning epileptic children and they are still controversial as to whether it is characteristic to epilepsy or not. We analyzed the behavioral problems both in the normally developed children with epilepsy and the normal control group with the same behavioral score and then investigated the differences between epileptic children with normal development and those with retardation. The study disclosed that the epileptic children had problems in almost all fields such as emotional disturbances, daily life activity and human relationship and these were associated with the development and control of seizures. The retarded children had the disorders more frequently than the normally developed epileptic children.     

The correlation of seizure characteristics and hippocampal volumetric magnetic resonance imaging findings in children with idiopathic partial epilepsy

Cerebral volumetric measurements based on magnetic resonance imaging have been established as advanced morphometric techniques with anatomic and clinical utility in adults and children with epilepsy. This study investigated the cerebral and hippocampal volumes in children with idiopathic partial epilepsy to detect the factors correlated with volume reduction. Magnetic resonance imaging volumetric measurements were performed of the total cerebral and hippocampal formation volumes in 30 patients with idiopathic partial epilepsy between 3 to 18 years old. The cerebral and the total, right, and left hippocampal volumes of the study and control patients were detected using volumetric magnetic resonance imaging, and the volumes were compared between the 2 groups. In study patients, the correlation between volumetric findings and seizure characteristics was evaluated. The results suggested that children with idiopathic partial epilepsy had significant hippocampal volume reduction that was not influenced by the age of onset and the duration of epilepsy.     

Inhibition of astroglial connexin43 hemichannels with TAT‐Gap19 exerts anticonvulsant effects in rodents

Accumulating evidence shows a key function for astrocytic connexin43 (Cx43) signaling in epilepsy. However, the lack of experimental distinction between Cx43 gap junction channels (GJCs) and hemichannels (HCs) has impeded the identification of the exact contribution of either channel configurations to epilepsy. We therefore investigated whether TAT‐Gap19, a Cx mimetic peptide that inhibits Cx43 HCs but not the corresponding Cx43 GJCs, influences experimentally induced seizures in rodents. Dye uptake experiments in acute hippocampal slices of mice demonstrated that astroglial Cx43 HCs open in response to the chemoconvulsant pilocarpine and this was inhibited by TAT‐Gap19. In vivo, pilocarpine‐induced seizures as well as the accompanying increase in D‐serine microdialysate levels were suppressed by Cx43 HC inhibition. Moreover, the anticonvulsant action of TAT‐Gap19 was reversed by exogenous D‐serine administration, suggesting that Cx43 HC inhibition protects against seizures by lowering extracellular D‐serine levels. The anticonvulsive properties of Cx43 HC inhibition were further confirmed in electrical seizure mouse models, i.e. an acute 6 Hertz (Hz) model of refractory seizures and a chronic 6 Hz corneal kindling model. Collectively, these results indicate that Cx43 HCs play a role in seizures and underscore their potential as a novel and druggable target in epilepsy treatment.     

Family factors and psychopathology in children with epilepsy: a literature review

PURPOSE: From a social interactional and ecological framework, studies were reviewed that (1) compared family factors in children with epilepsy with those in children from normative groups, healthy children, children with a chronic illness, or siblings; and (2) examined the relationship between distinct family factors and child psychopathology. RESULTS: Compared with control groups, families with a child with epilepsy generally fare worse on the whole range of family factors, indicating lower parent-child relationship quality, more depression in mothers, and problems with family functioning. Significant associations were apparent between distinct family factors, especially parental psychological control, parental attributions about epilepsy, and family members' satisfaction with family relationships, and psychopathology in children with epilepsy. CONCLUSION: Future childhood epilepsy research might benefit from the examination of the simultaneous contribution of distinct family factors to child psychopathology, within a broad multifactorial framework that also includes neurological and medication factors.