Behavioral problems of epileptic children at Queen Sirikit National Institute of Child Health.

BACKGROUND: Neurological diseases and psychiatric problems were cloudily related. Many patients with epilepsy had associated problems such as Learning disorders (LD) or Attention deficit hyperactivity disorder (ADHD). Evaluation and treatments of these behavioral and learning problems should be, therefore, included in management of patients with epilepsy in order to improve their quality of life. OBJECTIVE: To study behavioral, learning problems that indicate ADHD in epileptic children. MATERIAL AND METHOD: These was cross sectional study in 100 epileptic children, age 6- 11-years-old who visited Neurological Clinic at Queen Sirikit National Institute of Child Health. The patients were assessed with Thai Youth Checklist (TYC), IOWA screening test for ADHD and questionnaires concerning learning area. The data was analyzed in Chi-square, using SPSS program. RESULTS: The prevalence of behavioral problems in epileptic children was 57 percent. The prevalence of moderate to severe ones which should be treated and related to complex partial seizure was 32 percent. The prevalence of learning problems was 23 percent. Most were found in higher classes. The prevalence of behaviors that indicate ADHD was 23 percent from TYC and 58 percent from IOWA screening test for ADHD. There was relationship of behaviors that indicate ADHD and the severity of epilepsy. The prevalence of delinquent behavior was 24 percent and social problems were 32 percent respectively. Correlation of behavioral problems and social skills (p = 0.027), good manner toward parents (p = 0.015) and helping house chores (p = 0.016) were significantly different. However there was no significantly different between behavioral problems and age of onset as well as duration of epileptic symptom, frequency of seizures in the past 6 months, EEG results and combination of medication. CONCLUSION: The epileptic children had high risks of behavioral and learning problems; they may be prevented by intensive evaluation, proper interventions, adequate counseling, proper medication, parental training and proper rehabilitation.

375 childhood primary headache: clinical features, the agreement between clinical diagnosis and diagnoses using the international classification of headache disorders in Thai children.

OBJECTIVE: To study the clinical features of patients with headache and agreement between clinical diagnoses and ICHD II criteria diagnosis in primary headaches in Thai children. MATERIAL AND METHOD: Patients with headache who, over a 4-year period, consulted the neurological clinic, were interviewed by questionnaire, examined, diagnosed, treated, and followed up by pediatric neurologists. The result from the questionnaire was used to define the type of headache according to the ICHD II criteria. The clinical features were analyzed and clinical diagnosis was compared with diagnoses using the International Classification of Headache disorders. RESULTS: Three hundred and seventy-five primary headache patients were defined by ICHD II criteria. One hundred twenty eight (35.2%) were migraine, 47 (12.5%) were tension-type, 123 (33.3%) were probable migraine, 31 (8.3%) were probable tension-type, and 40 (10.7%) cannot be classified because the symptoms were not compatible with diagnosed criteria. Using clinical diagnosis as the standard, the sensitivity of the ICHD-based definition of migraine without aura and probable migraine was 89.96% whereas the specific was 65.09%. On the other hand, the sensitivity of the International Classification of Headache disorders-based definition of infrequent episodic tension-type and probable infrequent episodic tension-type was 56.34% whereas the specific was 87.50%. CONCLUSION: The present study shows the increase of sensitivity but decrease of the specificity of ICHD II criteria in diagnosed pediatric migraine headache. However, the duration of attack and quality of headache are still the limitation of diagnosis for pediatric headache. Therefore, the diagnosis criteria in pediatric headache should be developed distinctly from adults.