Sensory modulation disorders in childhood epilepsy.
BACKGROUND
Altered sensory sensitivity is generally linked to seizure-susceptibility in childhood epilepsy but may also be associated to the highly prevalent problems in behavioral adaptation. This association is further suggested by the frequent overlap of childhood epilepsy with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), conditions in which altered behavioral responses to sensory stimuli have been firmly established. A continuum of sensory processing defects due to imbalanced neuronal inhibition and excitation across these disorders has been hypothesizedthat may lead to common symptoms of inadequate modulation of behavioral responses to sensory stimuli. Here, we investigated the prevalence of sensory modulation disorders among children with epilepsy and their relation with symptomatology of neurodevelopmental disorders.


METHODS
We used the Sensory Profile questionnaire to assess behavioral responses to sensory stimuli and categorize sensory modulation disorders in children with active epilepsy (aged 4-17 years). We related these outcomes to epilepsy characteristics and tested their association with comorbid symptoms of ASD (Social Responsiveness Scale) and ADHD (Strengths and Difficulties Questionnaire).


RESULTS
Sensory modulation disorders were reported in 49 % of the 158 children. Children with epilepsy reported increased behavioral responses associated with sensory "sensitivity," "sensory avoidance," and "poor registration" but not "sensory seeking." Comorbidity of ASD and ADHD was associated with more severe sensory modulation problems, although 27 % of typically developing children with epilepsy also reported a sensory modulation disorder.


CONCLUSIONS
Sensory modulation disorders are an under-recognized problem in children with epilepsy. The extent of the modulation difficulties indicates a substantial burden on daily functioning and may explain an important part of the behavioral distress associated with childhood epilepsy.
Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands ; Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands.
Jolien S
JS
van Campen
Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands.
Floor E
FE
Jansen
Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands.
Nienke J
NJ
Kleinrensink
Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands.
Marian
M
Joëls
Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands.
Kees Pj
KP
Braun
Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands ; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center, KC03.063.0, PO Box 85090, Utrecht, 3508 AB The Netherlands.
Hilgo
H
Bruining
Epilepsy; Excitation; Seizures; Sensory modulation