Behaviour Problems in Children with Epilepsy

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Behaviour Problems in Children with Epilepsy

• Ann Brown
• Childrens Neurology Specialist Nurse

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INTRODUCTION

• Isle of Wight Study, Rutter et al. 1970
• Austin, 1989, Hoare, 1984a, Mc Dermott et al.
  1995
• Hoare, 1984a

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Definition of Epilepsy
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HISTORICAL BACKGROUND

• 1494 witch hunting
• 18th century Cullen
• 19th century asylums for psychiatric and
  epileptic patients
• 19th century Reynolds
• 20th century divergent views
• Eugenic Laws 1895
• 1951 - Gibbs

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COMPLEX PARTIAL SEIZURES

• Vulnerable to emotional activation of seizure
  activity reducing emotional distress may
  decrease the occurrence of the seizures.
• Attempts to restrain a child during or after a TC
  seizure or complex partial seizure may result in
  defensive or aggressive behaviour.
• Poor memory and memory loss are frequent
  complaints of the child with complex partial
  seizures.
• A psychosis resembling paranoid schizophrenia has
  been noted in some children.

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ICTALLY RELATED BEHAVIOUR

• Irritability or changes in the mood are common in
  the prodrome period (the period leading up to the
  seizure) which invariably remits once the seizure
  has occurred.
• The aura may affect behaviour if the subjective
  experience is of an unpleasant emotional
  sensation such as extreme fear or anxiety.
• Automatisms are movements or actions occurring in
  the ictal or post ictal phase of which the
  individual is unaware and over which they have no
  voluntary control.

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ICTALLY RELATED BEHAVIOUR

• Focal discharges may be manifest as odd and
  apparently bizarre behaviours which are not under
  their control.
• Frequent subtle seizures may not be accompanied
  by any obvious clinical activity but will
  inevitably interrupt an individuals consciousness
  and impair their ability to make sense of what is
  going on around them.
• In the post-ictal phase a child may remain in a
  confused state for some considerable time, as a
  result of which their powers of reasoning and
  understanding may be much reduced.