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SDQ screening for mental health conditions in children with epilepsy
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e u r o p e a n j o u r n a l o f p a e d i a t r i c n e u r o l o g y 2 1 ( 2 0 1 7 ) e 9 6 ee 1 0 8
P2-19 EEG appearance before and after VNS implantation in children with refractory epilepsy e Initial report ska, Marta Zawadzka, Marta Szmuda, Maria Mazurkiewicz-Bełdzin Małgorzata Pawłowicz, Agnieszka Matheisel. Department of sk, Gdan sk, Poland Developmental Neurology, Medical University of Gdan Objective: Vagus nerve stimulator is thought to be beneficial and effective method of treatment in pharmacoresistant epilepsy. Majority of scientific researches describe the adult population, less is known about the results of this therapy in pediatric patients. For this reason, we decided to assess the efficacy of this alternative method of treatment and concentrate specially on electroencephalographic presentation. Methods: We observed 8 patients, between 5 and 16 years of age, with implanted Vagus Nerve Stimulator due to the pharmacoresistant epilepsy. All patients underwent precise diagnostics, including prolonged videoEEG monitoring before and after this neurosurgical procedure. Clinical observation of patients lasted from 3 months before and up to one year after implantation. Results: Comparing to the initial EEG examination performed before surgery, none of the patients achieved marked improvement after one year observation. However, in the first 4 weeks after VNS implantation, 6 patients were seizure-free and presented transient significant reduction of epileptiform discharges in EEG. Conclusion: There was no significant or persistent improvement in EEG recordings after a one-year post-implantation observation. Assessment of VNS efficacy in children undoubtly need a longer follow-up on a larger and age-specified group of children.
http://dx.doi.org/10.1016/j.ejpn.2017.04.747 P2-20 The signifficance of focal EEG abnormalities in typical absence seizures e Long term observations ska, Marta Szmuda, Marta Zawadzka, Maria Mazurkiewicz-Bełdzin Małgorzata Pawłowicz, Agnieszka Matheisel, Marta Szmuda, Marta Zawadzka, Małgorzata Pawłowicz, Agnieszka Matheisel, Sandra Modrzejewska. Department of Developmental Neurology, sk, Gdan sk, Poland Medical University of Gdan Objective: In last years it becomes more and more evident that focal EEG changes can be detected in patients with idiopathic generalized epilepsies. In order to estimate the frequency of this changes and their possible prognostic value present study was undertaken. Methods: Patients with typical absence seizures who were hospitalized or consulted at Dept. of Developmental Neurology between 2000e2015 were included in the study and followed prospectively. All patients underwent video-EEG monitoring at regular intervals. 189 patients who fulfilled criteria for typical absence seizures were included in the study. In 17% of them we found interictal epileptiform discharges, and in 37% intermittent temporal slow waves. Results: We found significant correlation between presence of interictal focal epileptiform discharges and long term prognosis, but did not find the correlation between worse prognosis and presence of temporal interictal slow wave activity. Interestingly, we did not found correlation between presence of focal abnormalities and worse performance in cognitive tests. Conclusion: The value of focal interictal EEG abnormalities should not be overestimated according to prognosis and cognitive performance in children with CAE.
http://dx.doi.org/10.1016/j.ejpn.2017.04.748 P2-21 SDQ screening for mental health conditions in children with epilepsy O. Tame, I. Hadjikoumi, G. Colville, M. McGowan, S. Walsh. Department e Children's Development Centre, St George's University of London, London, United Kingdom Objective: Children with epilepsy are more likely to suffer mental health disorders, with estimates showing a prevalence between 56-62% for children with complicated epilepsy. A previous audit of the secondary epilepsy service (hereafter SES) at St Georges in 2014 showed 27% of the dataset to have psychiatric problems. This was thought to likely be an underestimate due to 1) the small dataset (n ¼ 45) and 2) the methodology of collection (a medical history with added questions about schooling and behaviour difficulties). Our objectives for this study were 1) to show that use of a standardised and specialised questionnaire is important for the accurate screening of mental health conditions and 2) that mental health conditions within the SES at St Georges have been underdiagnosed, with potential for a greater number of patients to benefit from a referral to psychology/mental health services. Methods: The Strengths and Difficulties Questionnaire (hereafter SDQ) version P4-17 (completed by parents of children aged 4e17) was provided to 211 patients within the paediatric epilepsy cohort of the SES at St Georges. Selection criteria was all patients aged 4e17 with diagnosed epilepsy. The SDQs were scored (out of a possible 40) as: 0e13 ¼ close to average 14e16 ¼ slightly raised [risk of having mental health disorders] 17e19 ¼ high 20e40 ¼ very high. Results: As of 17/1/17, 62 SDQs had been returned showing preliminary findings of 55% of the cohort in the high/ very high risk group, and 30% in the very high risk group alone. Conclusion: We conclude that the previous audit of the SES at St Georges underestimated the prevalence of mental health disorders within the cohort, and that accuracy of diagnosis is improved using the SDQ. The findings highlight the need for more resource allocation of psychology input to the SES.
http://dx.doi.org/10.1016/j.ejpn.2017.04.749 P2-22 Quality of care of children with symptomatic epilepsy with lissencephaly Guzeva Valentina Ivanovna, Ochrim Inna Vladimirovna, Guzeva Viktoria Valentinovna, Guzeva Oksana Valentinovna, Kasumov Vugar Raufovich, Maksimova Nadezhda Evgenevna. St. Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation, Russia Objective: Study and compare the clinical and electrophysiological and neuroimaging findings in children with symptomatic epilepsy with lissencephaly, assess the effectiveness of antiepileptic therapy and quality of life of sick children. Methods: The study involved 22 children. Submitted neurological examination, brain MRI (magnetic resonance imaging), EEG (electroencephalography). Results: Neuroimaging in the survey equally revealed pachygyria (50%) and agyria (50%). The 9.09% noted a combination of these anomalies. The debut of epileptic seizures significantly more often observed in the age of six months (50%) (p ¼ 0.0304). The predominance of epileptic spasms in the debut of epilepsy (50%). Were reported more often by focal seizures with secondary generalization and without secondary
e u r o p e a n j o u r n a l o f p a e d i a t r i c n e u r o l o g y 2 1 ( 2 0 1 7 ) e 9 6 ee 1 0 8
P2-19 EEG appearance before and after VNS implantation in children with refractory epilepsy e Initial report ska, Marta Zawadzka, Marta Szmuda, Maria Mazurkiewicz-Bełdzin Małgorzata Pawłowicz, Agnieszka Matheisel. Department of sk, Gdan sk, Poland Developmental Neurology, Medical University of Gdan Objective: Vagus nerve stimulator is thought to be beneficial and effective method of treatment in pharmacoresistant epilepsy. Majority of scientific researches describe the adult population, less is known about the results of this therapy in pediatric patients. For this reason, we decided to assess the efficacy of this alternative method of treatment and concentrate specially on electroencephalographic presentation. Methods: We observed 8 patients, between 5 and 16 years of age, with implanted Vagus Nerve Stimulator due to the pharmacoresistant epilepsy. All patients underwent precise diagnostics, including prolonged videoEEG monitoring before and after this neurosurgical procedure. Clinical observation of patients lasted from 3 months before and up to one year after implantation. Results: Comparing to the initial EEG examination performed before surgery, none of the patients achieved marked improvement after one year observation. However, in the first 4 weeks after VNS implantation, 6 patients were seizure-free and presented transient significant reduction of epileptiform discharges in EEG. Conclusion: There was no significant or persistent improvement in EEG recordings after a one-year post-implantation observation. Assessment of VNS efficacy in children undoubtly need a longer follow-up on a larger and age-specified group of children.
http://dx.doi.org/10.1016/j.ejpn.2017.04.747 P2-20 The signifficance of focal EEG abnormalities in typical absence seizures e Long term observations ska, Marta Szmuda, Marta Zawadzka, Maria Mazurkiewicz-Bełdzin Małgorzata Pawłowicz, Agnieszka Matheisel, Marta Szmuda, Marta Zawadzka, Małgorzata Pawłowicz, Agnieszka Matheisel, Sandra Modrzejewska. Department of Developmental Neurology, sk, Gdan sk, Poland Medical University of Gdan Objective: In last years it becomes more and more evident that focal EEG changes can be detected in patients with idiopathic generalized epilepsies. In order to estimate the frequency of this changes and their possible prognostic value present study was undertaken. Methods: Patients with typical absence seizures who were hospitalized or consulted at Dept. of Developmental Neurology between 2000e2015 were included in the study and followed prospectively. All patients underwent video-EEG monitoring at regular intervals. 189 patients who fulfilled criteria for typical absence seizures were included in the study. In 17% of them we found interictal epileptiform discharges, and in 37% intermittent temporal slow waves. Results: We found significant correlation between presence of interictal focal epileptiform discharges and long term prognosis, but did not find the correlation between worse prognosis and presence of temporal interictal slow wave activity. Interestingly, we did not found correlation between presence of focal abnormalities and worse performance in cognitive tests. Conclusion: The value of focal interictal EEG abnormalities should not be overestimated according to prognosis and cognitive performance in children with CAE.
http://dx.doi.org/10.1016/j.ejpn.2017.04.748 P2-21 SDQ screening for mental health conditions in children with epilepsy O. Tame, I. Hadjikoumi, G. Colville, M. McGowan, S. Walsh. Department e Children's Development Centre, St George's University of London, London, United Kingdom Objective: Children with epilepsy are more likely to suffer mental health disorders, with estimates showing a prevalence between 56-62% for children with complicated epilepsy. A previous audit of the secondary epilepsy service (hereafter SES) at St Georges in 2014 showed 27% of the dataset to have psychiatric problems. This was thought to likely be an underestimate due to 1) the small dataset (n ¼ 45) and 2) the methodology of collection (a medical history with added questions about schooling and behaviour difficulties). Our objectives for this study were 1) to show that use of a standardised and specialised questionnaire is important for the accurate screening of mental health conditions and 2) that mental health conditions within the SES at St Georges have been underdiagnosed, with potential for a greater number of patients to benefit from a referral to psychology/mental health services. Methods: The Strengths and Difficulties Questionnaire (hereafter SDQ) version P4-17 (completed by parents of children aged 4e17) was provided to 211 patients within the paediatric epilepsy cohort of the SES at St Georges. Selection criteria was all patients aged 4e17 with diagnosed epilepsy. The SDQs were scored (out of a possible 40) as: 0e13 ¼ close to average 14e16 ¼ slightly raised [risk of having mental health disorders] 17e19 ¼ high 20e40 ¼ very high. Results: As of 17/1/17, 62 SDQs had been returned showing preliminary findings of 55% of the cohort in the high/ very high risk group, and 30% in the very high risk group alone. Conclusion: We conclude that the previous audit of the SES at St Georges underestimated the prevalence of mental health disorders within the cohort, and that accuracy of diagnosis is improved using the SDQ. The findings highlight the need for more resource allocation of psychology input to the SES.
http://dx.doi.org/10.1016/j.ejpn.2017.04.749 P2-22 Quality of care of children with symptomatic epilepsy with lissencephaly Guzeva Valentina Ivanovna, Ochrim Inna Vladimirovna, Guzeva Viktoria Valentinovna, Guzeva Oksana Valentinovna, Kasumov Vugar Raufovich, Maksimova Nadezhda Evgenevna. St. Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation, Russia Objective: Study and compare the clinical and electrophysiological and neuroimaging findings in children with symptomatic epilepsy with lissencephaly, assess the effectiveness of antiepileptic therapy and quality of life of sick children. Methods: The study involved 22 children. Submitted neurological examination, brain MRI (magnetic resonance imaging), EEG (electroencephalography). Results: Neuroimaging in the survey equally revealed pachygyria (50%) and agyria (50%). The 9.09% noted a combination of these anomalies. The debut of epileptic seizures significantly more often observed in the age of six months (50%) (p ¼ 0.0304). The predominance of epileptic spasms in the debut of epilepsy (50%). Were reported more often by focal seizures with secondary generalization and without secondary