Implementation of a (neuro-)psychological screening of infants with newly diagnosed epilepsy. Practicability and first results concerning potential premorbid problems

Aims: Children with epilepsy have an increased risk for comorbid cognitive and behavioral problems. When compared with groups with other chronic diseases, attention deficits, anxiety, and depressive symptoms are described more frequently. For the treatment of these patients information on problems before the beginning of illness or whether they emerge in the course of chronic illness would be highly relevant. Hence, we implemented a (neuro-) psychological screening for children with newly diagnosed epilepsy.

Methods: Before starting antiepileptic medication (AED), children from the age of 6 years were assessed with a screening tool on attention and executive functions, Epitrack Junior. Cognitive and behavioral problems were assessed with questionnaires (CBCL 4 – 18, KOPKJ). All procedures were repeated 3 months after titration and treatment and counseling was provided with respect to the results.

Results: Since implementation, 66 children aged 6 to 17 years were assessed at the before titration of AED. Screening with EpiTrack Junior showed good practicability with short assessment duration (10 to 15 minutes) but was not applicable to children younger than 6 years or those with global developmental delay. Acceptance of questionnaires was high (response rate 71%) but limited with respect to other languages than German. Compared with normative samples, patients had higher proportion of borderline/impaired results in EpiTrack Junior (28%) and higher rates of internalizing problems in parent ratings (34%; CBCL).

Conclusion: First results of a neuropsychological screening point to potential premorbid cognitive and behavioral problems in children with newly diagnosed epilepsy. These have to be considered as risk factors for maladaptation to the chronic disease and underpin the importance of follow-up and counseling of these patients.