Behavioral problems in children with epilepsy

Background Epilepsy is a neurological disorder that most often affects children. Most cases of epilepsy are found in developing countries. Children with epilepsy are at risk of behavioral disorders that can affect their quality of life. Studies on behavioral problems in children with epilepsy have been limited in Indonesia. Objective To compare behavioral disorders in children with epilepsy to those in normal children, and to assess for possible factors associated with the occurrence of behavioral disorders. Methods We conducted a cross-sectional study involving 47 children with epilepsy and 46 children without epilepsy, aged 3-16 years. Behavioral problems were screened with the Strength and Difficulty Questionnaire (SDQ), Indonesian version. Information about EEG description, medication, onset, and duration of epilepsy were obtained from medical records. Results Behavioral problems were found in 19.1% of children with epilepsy and only in 2.2 % of children without epilepsy (PR 8.8; 95%CI 1.16 to 66.77; P= 0.015). Significant differences were also found in the percentage of conduct problems and emotional disorders. Multivariate analysis with logistic regression revealed that the factors associated with behavioral disorders in children with epilepsy were uncontrolled epilepsy (PR 13.9; 95%CI 1.45 to 132.4; P=0.023) and focal EEG appearance (PR 19; 95%CI 1.71 to 214.43; P=0.017). We also found that uncontrolled epilepsy was a factor related to emotional (PR 6.7; 95%CI 1.66 to 26.76; P=0.007) and conduct problems (PR 6.1; 95%CI 1.35 to 27.29; P=0.019). Conclusion Uncontrolled epilepsy and focal EEG results are factors associated with increased risk of behavioral problems in children with epilepsy. Children with epilepsy should undergo behavioral disorder screening, followed by diagnosis confirmation and treatment.