title: Recurrent seizures and behavior problems in children with first recognized seizures: a prospective study.
abstract: OBJECTIVE
  Children with epilepsy have high rates of behavior problems. The purpose was to describe prospectively the association of seizures and behavior problems in children with new-onset seizures.
  
  
  METHODS
  Subjects were 224 children with new-onset seizures (aged 4-14 years) and 159 siblings (4-18 years). Caregiver's ratings of the behavior were collected 4 times: at baseline, and at 6, 12, and 24 months. During the 2-year period, 163 (73%) children had at least one additional seizure, and 61 (27%) had none. Data were analyzed by using repeated measures analysis of variance both with and without covariates [site, age, gender, race, caregiver education (years), and seizure medications].
  
  
  RESULTS
  On average, children had higher CBCL Total and Internalizing Behavior Problems scores across all times when experiencing recurrent seizures than when not experiencing recurrent seizures (Total Problems, p = 0.041, controlling for demographics and seizure medications). Siblings had significantly lower Total and Internalizing Problems scores than both children experiencing (Total Problems adjusting for covariates, p = 0.0001) and not experiencing recurrent seizures (p = 0.0004). Externalizing Problems scores were not significantly different among children with recurring seizures, children without recurring seizures, and siblings.
  
  
  CONCLUSIONS
  Recurrent seizures significantly predicted behavior problems very early in the course of a seizure condition, even when key child, demographic, and seizure variables were controlled. Explanations for these findings include the possibilities that both seizures and behavior problems are caused by an underlying neurological disorder, that seizures per se disrupt behavior, or that children have negative psychological responses to seizure activity.
authors.affiliation: Environments for Health, School of Nursing, Indiana University, Indianapolis, 46202-5107, USA. joausti@iupui.edu
authors.forename: Joan K
authors.initials: JK
authors.lastname: Austin
authors.forename: David W
authors.initials: DW
authors.lastname: Dunn
authors.forename: Helena M
authors.initials: HM
authors.lastname: Caffrey
authors.forename: Susan M
authors.initials: SM
authors.lastname: Perkins
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Harezlak
authors.forename: Douglas F
authors.initials: DF
authors.lastname: Rose
mesh_terms: D000293:Adolescent; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D010552:Personality Assessment; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors