Treatment of interictal epileptiform discharges can improve behavior in children with behavioral problems and epilepsy.
OBJECTIVE
It is generally agreed that children should be treated for epilepsy only if they have clinical seizures. The aim of this study was to examine whether suppressing interictal discharges can affect behavior in children with epilepsy.


METHODS
In a double-blinded, placebo-controlled, crossover study, 61 children with well-controlled or mild epilepsy were randomly assigned to add-on therapy with either lamotrigine followed by placebo or placebo followed by lamotrigine. Ambulatory electroencephalographic recordings and behavioral scales were performed during baseline and at the end of placebo and drug phases. The primary hypothesis to be tested was that behavioral scales would improve specifically in patients with a reduction of electroencephalographic discharges during active drug treatment.


RESULTS
Global rating of behavior significantly improved only in patients who showed a significant reduction in either frequency ( P < .05) or duration of discharges ( P < .05) during active treatment but not in patients with without a significant change in discharge rate. This improvement was mainly seen in patients with partial epilepsy ( P < .005).


CONCLUSIONS
Our data suggest that suppressing interictal discharges can improve behavior in children with epilepsy and behavioral problems, particularly partial epilepsy. Focal discharges may be involved in the underlying mechanisms of behavioral problems in epilepsy.
Pressler
Ronit M
RM
Department of Clinical Neurophysiology, King's College London, London, UK. ronit.pressler@uclh.org
Robinson
Richard O
RO
Wilson
Goigia A
GA
Binnie
Colin D
CD
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000517:prevention & control*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D011581:Psychological Tests; D014227:Triazines / Q000627:therapeutic use*
D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine