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Embargoed for release until December 8, 2014 TIME 11: 45 AM PT / 2:45 PM ET

Newswise SEATTLE, December 8, 2014 Children with epilepsy can face greater intellectual and behavioral problems compared to their peers. New research presented at the American Epilepsy Societys (AES) 68th Annual Meeting explores the complex emotional, behavioral and intellectual disabilities associated with childhood epilepsy and their effect on development.

The first of three studies (Platform Session A.04) presents a culmination of 20-30 years of research that sought out to understand if intellectual disability (ID) predicts a low chance of remission and a high risk of intractability in epilepsy. Researchers of this study focused on examining the severity of ID to predict epilepsy outcome.

A cohort of children from Nova Scotia who developed epilepsy between 1977 and 1985 and had ID was followed for an average of 21 years following diagnosis. The initial study followed 692 children with incident epilepsy, of which 147 (21%) had intellectual disability. The degree of intellectual disability was established by standard psychometric testing around 5 years of age, and confirmed by subsequent academic achievements.

Researchers at Dalhousie University found that the degree of intellectual disability in children with epilepsy did predict seizure outcome. Mild intellectual disability was associated with a substantially better prognosis for remission and absence of intractability than moderate or severe/profound ID. Focal epilepsy and mild intellectual disability had the same rate of remission and intractability as focal epilepsy with normal intelligence. While mild ID seriously affects social outcome, it is not an important prognostic factor for seizure outcome, particularly if the epilepsy is focal.

The level of ID varied by the type of epilepsy present, with focal epilepsy apparent in 70% with mild ID, 38% with moderate and 29% with severe/profound ID. Generalized symptomatic epilepsies were most common with moderate (53%) and severe/profound ID (65%) than with mild ID (13%). Participants with mild ID were more likely to be in remission at the end of the twenty-year follow up (50%) than moderate (34%) or severe/profound ID (28%). Intractable epilepsy was more common with moderate (35%) and severe/profound (59%) than with mild ID (17%).

Mild intellectual disability has a profound effect on a childs adaptation to adult life, said Dr. Peter Camfield, M.D., Professor Emeritus, Department of Pediatrics, Dalhousie University. However, it is not particularly associated with severe epilepsy. Moderate to severe ID has ominous implications for seizure control.

A second study (Poster 1.097) explores the relationship between behavioral/psychiatric disorders and childhood epilepsy. Researchers at Northwestern Universitys Feinberg School of Medicine referenced children with the Connecticut Study of Epilepsy (CSE) that were recruited between 1993 and 1997, and underwent comprehensive reassessments between 2002 and 2006, 8 to 9 years after they were diagnosed with epilepsy. Within those 16 years, cognitive testing was conducted with a Wechsler IQ test and behavioral assessment with the parent-reported Child Behavior Check List (CBCL). Controls of this study were similar-aged siblings without epilepsy who received the same assessment instruments.

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Behavioral and Intellectual Disabilities in Pediatric Epilepsy Examined in Three Studies at AES Annual Meeting