Long-term behavioural outcomes after paediatric convulsive status epilepticus: a population-based cohort study.
Marina M Martinos, Suresh Pujar, Christopher Gillberg and 5 others
PMID 29226310WHAT IT FOUND
Children who had convulsive status epilepticus, even without epilepsy, showed more behavioural problems than peers.
Screening should not stop at seizure control, as many issues go undetected. Those with lower IQ or prior seizures were at highest risk.
Key findings
01Children with CSE scored significantly higher on behavioural problem scales than population norms, regardless of whether they had epilepsy.
02Pre-existing seizures and recurrent CSE were associated with worse behavioural outcomes in children with epilepsy-related CSE.
03Full-scale IQ was strongly associated with long-term behavioural outcomes, suggesting it helps identify children at risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only 41% of the original CSE cohort returned questionnaires, and those who did not were more likely to have severe cognitive impairments, meaning the study may underestimate the true burden of behavioural problems. The control group was recruited from hospital staff and charity networks, which may not represent the general population, as controls scored lower than population norms on some measures. Many children who screened positive for behavioural problems did not attend the follow-up psychiatric assessment, so the detailed diagnosis data is based on a small subset (19 children). The study relied on parental report for developmental history and behavioural symptoms, which can be subjective.
Declared interests
The authors declared no conflicts of interest. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not assume that children without epilepsy after CSE are free of behavioural risk. The study found that non-epilepsy CSE children also scored significantly higher than norms on behavioural problem scales, and many had undiagnosed autism or ADHD. Screening should be applied to all children with a history of CSE, not just those with active epilepsy.