Vol. 8, No. 3, 2002 Page 4


Childhood seizures offer insight into problem behavior

A study of children with newly diagnosed seizures provides strong evidence that undetected neurological dysfunction can underlie classroom behavior problems.

David Dunn and colleagues evaluated 192 children with new-onset seizures (including 129 with no prior episodes and 63 with previous episodes suggestive of seizures), reviewing their behavior during the period two months prior to their first recognized seizures. They also evaluated a control group of 78 newly-diagnosed asthmatic children.

Analyzing teacher reports, the researchers found that children with new-onset seizures exhibited more thought problems than those with asthma, and that children with previous seizure-like episodes exhibited higher scores than those with first-time seizures on scales measuring total behavior problems, internalizing problems, physical complaints, anxiety and depression, thought problems, and attention problems.

The researchers conclude that "children with prior unrecognized seizures were already at increased risk of teacher-rated behavior problems before starting medication and before any possible stigma effects related to seizures." This indicates, they say, that the children's underlying neurological problems caused both the seizures and the aberrant behavior.

In a similar, earlier study, the same research group compared the behavior of 224 children who had experienced a first recognized seizure to the behavior of their siblings, using telephone interviews with the children's mothers. The children with seizures had significantly higher scores on scales measuring total behavior problems, internalizing behaviors, attention problems, thought problems, and physical complaints when compared to the siblings closest to their age. The most problems were seen in children with suspected earlier seizures, with nearly 40 percent of this group scoring in the clinically significant or at- risk range. "These findings are consistent," the researchers say, "with the hypothesis that in some children, epilepsy is a pervasive condition that includes both seizures and behavioral problems."

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"Teacher assessment of behaviour in children with new-onset seizures," David W. Dunn, Jaroslaw Harezlak, Walter T. Ambrosius, Joan K. Austin, and Bradford Hale, Seizure, Vol. 11, No. 3, April 2002, 169-75.

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"Behavior problems in children before first recognized seizures," J. K. Austin, J. Harezlak, D. W. Dunn, G. A. Huster, D. F. Rose, and W. T. Ambrosius, Pediatrics, Vol. 107, No. 1, January 2001, 115-22.

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Address for either article: David Dunn, Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202.

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