Abstract

Behavioural and emotional comorbidity of acute seizures in young children: a population-based study

Kariuki S, Abubakar A, Kombe M, Kazungu M, Odhiambo R, Stein A, Newton C
32nd International Epilepsy Congress. 2017;58

Permenent descriptor

Purpose: Acute seizures in young children in Africa may be associated with poor behavioural and emotional problems. It is unclear if behavioural and emotional comorbidities of acute seizures are related to the seizures, or shared genetic susceptibility and neurological damage. Method: We conducted a population-based study on 3,273 young children aged 1–6 years on the Kenyan coast to examine the relationship between acute seizures and behavioural and emotional problems, and to determine the factors associated with the comorbidity. Prevalence of behavioural and emotional problems was derived from the inverse link of a logit model. Generalised linear models were used to measure the independent association between acute seizures and behavioural and emotional problems, and to determine associated risk factors. Sobel-Goodman mediation tests were used to perform mediation analysis. Results: The crude prevalence of total behavioural and emotional problems was 30% (95%CI, 20%-43%) for children with acute symptomatic seizures and 25% (95%CI, 15%-38%) for those with febrile seizures; being greater than for those without seizures (11% (95%CI, 11%-12%); Chi-squared p≤0.001). Behavioural and emotional scores were higher in acute seizures than in those without seizures (Cohens d=0.44 (95%CI, 0.30–0.59)). Acute seizures were associated with total behavioural and emotional problems (risk ratio (RR)=1.92 (95%CI, 1.34–2.77)) after accounting for sociodemographic and medical confounders. The proportion of total effects of acute seizures on behavioural and emotional problems mediated by epilepsy was small (15.3% (95%CI, 4.5–34.9%)). Among children with acute seizures, important risk factors for mental health comorbidity included family history of febrile seizures (RR=3.36 (95%CI, 1.34–8.41)) for total problems, repetitive acute seizures (beta coefficient=0.36(95%CI, 0.15–0.57)) for externalizing problems and focal acute seizures (RR=1.80 (95%CI, 1.05–3.08)) for internalising problems. Conclusion: Acute seizures are associated with substantial behavioural and emotional problems, which should be assessed and addressed in children with these seizures in this rural area of Kenya.