Parental report of quality of life in children with epilepsy: A Spanish/French comparison.

BACKGROUND: Epilepsy is a chronic neurological condition that affects the quality of life (QoL) of patients and their families. In this study, we compare two sets of reports on QoL that were completed by two samples of parents whose children have epilepsy. METHOD: Parents of children with various types of epilepsy from Spain (N = 196) and France (N = 219) completed the same QoL questionnaire. Medical variables were recorded from the referred specialist doctor for each patient. RESULTS: The factors associated with parental reports on QoL were similar in both countries. Parents of children with nonidiopathic generalized or unclassified epilepsy reported poorer QoL and the highest proportion of learning and behavioral problems. However, the intensity of difficulties varied between the two samples. CONCLUSIONS: This questionnaire made it possible to detect comorbidities and daily life difficulties in children with epilepsy and their families. The type of epilepsy had the same influence on Spanish and French families' ratings of QoL. Families shared the same comorbidities in terms of hyperactivity/attention/sociability problems. Nevertheless, the intensity of reported difficulties varied in both countries, possibly because of differences in cultural and educational environments. This aspect should be further explored in future research.

Epilepsia generalizada idiopática con ausencias típicas tratada con ácido valproico: alteraciones neuropsicológicas / Idiopathic generalized epilepsies with absence seizures with valproic acid treatment: neuropsychological disorders

Objetivo. Investigar el perfil neuropsicológico de niños con crisis de ausencias típicas tratados con ácido valproico. Sujetos y métodos. Se compara una muestra de 34 niños (14 niños y 20 niñas) de 7 a 12 años con diagnóstico de ausencias típicas en tratamiento con ácido valproico (dosis media 30 mg/kg/día) con un grupo de referencia (28 niños sin problemas neurológicos). El perfil neuropsicológico se estima mediante la escala de inteligencia Wechsler para niños revisada y la batería neuropsicológica de Luria-diagnóstico neuropsicológico infantil. Resultados. Los niños con crisis de ausencias típicas con ácido valproico presentan un cociente intelectual verbal significativamente menor que los niños del grupo de referencia, aunque el cociente intelectual manipulativo y el total no difieren significativamente; un perfil neuropsicológico con puntuaciones significativamente menores que el grupo de referencia en todas las áreas, excepto en regulación verbal, cinestesia y estereognosia, percepción visual, comprensión simple y comprensión gramatical; un deterioro importante en memoria lógica, memoria inmediata, aritmética, estructura numérica, lectura, escritura, denominación y articulación; un déficit mnésico global, especialmente en memoria remota, memoria visual inmediata, memoria inmediata y memoria lógica; y alteraciones atencionales importantes. Conclusiones. Debemos considerar el perfil neuropsicológico alterado con la finalidad de programar tratamientos neuropsicológicos y rehabilitación de la memoria y la atención. Por ello, reivindicamos la necesidad de dotar las consultas de neuropediatría con neuropsicólogos que garanticen el análisis sistemático de las dificultades cognitivas y neuropsicológicas tanto en el momento del diagnóstico de la epilepsia como en su seguimiento, así como el apoyo escolar de estos pacientes (AU)

Aim. To analyze the neuropsychological profile of children with absence seizures treated with valproate. Subjects and methods. Sample of 34 children from 7 to 12 years with absence seizures treated with valproate (median dose: 30 mg/kg/day) and 28 controls. We get the neuropsychological profile by applying the Wechsler Intelligence Scale for Children-Revised (WISC-R) and Luria-DNI Battery. Results. Children with absence seizures manifest verbal IQ significantly lower (p < 0.05) than the control group but within normal. The neuropsychological profile Luria-DNI is significantly lower (p < 0.05) than the control group in all areas except in regulation verbal, kinesthetic, visual perception, comprehension and understanding simple grammar. This is a serious deterioration profile in the areas of logical memory, short-term memory, arithmetic, numerical structure, reading, writing, naming, and articulation. Children with absence seizures have a significant memory deficit. Memory profile measured with the Luria-DNI Battery and the WISC-R appears generally deteriorated when compared with the control group (p < 0.001) although there is a paradoxical preservation of shape memory. The short-term auditory and visual memory and logical memory are particularly affected. In the epileptic group, the attentional profile (estimated by the ‘third factor of the WISC-R’) is generally deteriorated when compared with the control group. Conclusions. We consider in children with this diagnosis and treatment, the neuropsychological profile described to strengthen deficient neuropsychological and psychoeducational areas. Above, we claim the need, in the consultations of neuropediatrics, the neuropsychlogists to ensure the systematic analysis of neuropsychological and cognitive difficulties both at the time of the diagnosis and follow-up of epilepsy (AU)