Does a child have new onset seizures or epilepsy? Screen for Developmental Problems as Part of a Comprehensive Approach

As an epilepsy specialist, my office will screen test and treat for developmental concerns in patients with epilepsy. - JR
The American Academy of Neurology and the Child Neurology Society published recommendations for developmental screening tools with good sensitivity and specificity.
Routine developmental, autism, behavioral, and psychological screening in epilepsy care settings

Soyong Eom¹, 

Breanne Fisher¹, 

Catherine Dezort¹ and

Anne T Berg^1,

Aim

Screening for cognitive impairment, developmental delay, and neuropsychiatric problems is not always performed in children with epilepsy. The aim of this study was to assess the value of this screening and its validity for determining previously unidentified (‘actionable’) problems in children with epilepsy.

Method

New and existing patients with epilepsy were recruited from a hospital-based epilepsy center. The parent of the child completed screening evaluations for development (Ages and Stages Questionnaire [ASQ], 0–66mo), autism (Modified Checklist for Autism in Toddlers [mCHAT], 16–30mo), social communication (Social Communication Questionnaire [SCQ], ≥4y), and psychiatric concerns (Strengths and Difficulties Questionnaire [SDQ], 4–17y).

Results

We screened 236 children overall (136 males [58%], 100 females [42%]; mean age [SD] 6y 7mo [4y 6mo]). Of these, 176 children (75%) had established epilepsy diagnoses and 60 (25%) were patients with new-onset epilepsy. Of those with new-onset disease, 22 (37%) were determined not to have epilepsy. Positive findings by test were 82% (ASQ), 54% (mCHAT), 15%, (SCQ), and 58% (SDQ). Findings were actionable in 46 children (20%): 18% of findings in children with established epilepsy and 23% of findings in patients with new-onset epilepsy. Of the 46 children for whom further referrals were made, the parents of 28 (61%) have pursued further evaluations.

Interpretation

In this study, children with existing and new-onset diagnoses of epilepsy had actionable screening findings. These findings support the development of systematic screening of comorbidities for children with epilepsy.