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Epilepsy, Cognition and Behavior

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Abstract

Epilepsy is defined as two or more unprovoked seizures. Epileptic patients have intellectual disability and behavioral co-morbidities to the tune of up to 25 and 75% respectively. Various factors like underlying etiology, socioeconomic environment at home, age at onset, seizure semiology, seizure descriptors like duration, severity and frequency, therapy related adverse effects secondary to antiepileptic drugs and epilepsy surgery have been implicated for the causation of cognitive and behavioral impairment in epilepsy. Cognitive epilepsy has emerged as a specific entity. This may manifest as a transient behavioral or cognitive change, insidous onset subacute to chronic encephalopathy or more catastrophic in the form of nonconvulsive status epilepticus. Cognitive impairment seen in epileptic children include difficulties in learning, memory, problem solving as well as concept formation. Anxiety, depression and attention deficit hyperkinetic disorders are the most common psychiatric co-morbidities seen. Investigating a child with epilepsy for cognitive and behavioral impairment is difficult as these tests would require cooperation from the patient’s side to a significant extent. A rational approach towards treatment would be judicious selection of antiepileptic drugs, treatment of underlying cause, appropriate management of behavioral co-morbidities including psychopharmacotherapy and a trial of immunotherapy (particularly in cognitive epilepsies), wherever appropriate.

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Contributions

SY and BC prepared the manuscript under the supervision of SG. SG will act as guarantor for this paper.

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Authors and Affiliations

  1. Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India

    Sheffali Gulati, Sangeetha Yoganathan & Biswaroop Chakrabarty

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  1. Sheffali Gulati
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  2. Sangeetha Yoganathan
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  3. Biswaroop Chakrabarty
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Correspondence to Sheffali Gulati.

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Gulati, S., Yoganathan, S. & Chakrabarty, B. Epilepsy, Cognition and Behavior. Indian J Pediatr 81, 1056–1062 (2014). https://doi.org/10.1007/s12098-014-1530-4

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  • DOI: https://doi.org/10.1007/s12098-014-1530-4

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