Behavioural and neuropsychological problems in refractory paediatric epilepsies

The associated behavioural and neuropsychological profiles were studied in 573 children with refractory epilepsy, admitted in our residential Rehabilitation and Epilepsy Unit during the period 1984-2000. The aim of this study was to look for possible correlations between epileptic categories and behavioural profiles. The most frequent neuro-behavioural correlates in the different epilepsy categories were pervasive disorders (48/573=8%), attentional problems (43/573=7.5%), loss of self-esteem (n=49 or 9%) and self-induction of seizures (n=34 or 7%). Pervasive disorders were significantly more frequent in secondary generalised epilepsies. In 86/573 children (15%), mental decline due to epileptic process itself was observed. As expected this was seen in all patients with Lennox-Gastaut syndrome, West syndrome, severe myoclonic epilepsy of infancy and in continuous spikes and slow waves during slow wave sleep. The only behavioural problem that was more frequent in females was self-induction of seizures.