The psychological challenges of epilepsy

Children in Saudi Arabia with idiopathic generalised epilepsy (IGE) experience depression, anxiety and behavioural problems more often than healthy children. The finding was published in the journal EC Neurology. 

Epilepsy affects approximately 50 million people worldwide. Patients experience recurrent seizures due to a surge in electrical activity in the brain. More than 15 types of seizure and 30 different epilepsy syndromes have been described. 

IGE accounts for nearly a third of all epilepsies. Patients with IGE often have a family history of epilepsy and are genetically predisposed to the risk of seizures. The disease manifests in early childhood with seizures involving brief episodes of involuntary whole-body movement, and in some cases loss of consciousness and control of bowel or bladder function.  

Some patients outgrow their epilepsy during adolescence, but others require lifelong medication and monitoring. Despite the variety of antiepileptic drugs on the market, current medications fail to control seizures in about a third of patients. 

Several studies have shown that children with any type of epilepsy have a higher risk of developing behavioural and emotional problems than children with other chronic diseases or healthy children. Muhammad Talal Alrifai and colleagues at King Abdullah Specialized Children Hospital and King Saud bin Abdulaziz University for Health Sciences in Riyadh explored the incidence of these problems in 44 children with IGE between the ages of five and 18 using a questionnaire-based survey. 

The parents of the 44 patients and those of 89 healthy children were asked to rate 35 items as ‘never’, ‘sometimes’ or ‘often’ present using a standard paediatric symptom checklist that screens children for common psychological and behavioural problems.  

They found that children with IGE experienced more trouble sleeping, and were more likely to fidget and more easily distracted than the healthy children. This could help explain why they tend to perform worse academically.  

They also felt unhappy and angry more often than the healthy children and were more likely to act younger than their age and blame others for their troubles, indicating a higher prevalence of depression, anxiety and behavioural problems. There were no differences between the results of the boys and the girls surveyed.  

“In light of these findings, we recommend referring all recently diagnosed patients to a psychiatrist, a psychologist and a social worker for support,” says Al Rifai. 

Although further research is required to determine whether the frequency of seizures, age and IQ are associated with emotional and behavioural problems, the possibility of identifying and treating them early will improve patients’ quality of life and perhaps their school performance.

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