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THE JOURNAL OF ENGLISH RESEARCH

Neurobehavioral Comorbidities in Children with Epilepsy

Modage Anita1, Gajre Mona P1* and Setia Maninder2

1
Division of Neurology, Epilepsy and Developmental Pediatrics, LTMMC & LTMGH, Sion,
Mumbai, India
2
Clinical epidemiologist, LTMMC & LTMGH, Sion, Mumbai, India
*Corresponding author: Mona P Gajre, Division of Neurology, Epilepsy and Developmental
Pediatrics, LTMMC& LTMGH, Sion, Mumbai, India, E-mail:
monapote@yahoo.co.in

Arranged By:

EFI RULLI GUSWATI (10215009)

FITRIAH NURUL H. (10215010)

PROGRAM STUDI S1 KEPERAWATAN

INSTITUT ILMU KESEHATAN BHAKTI WIYATA KEDIRI

2017

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 FOREWORD

All praise and gratitude I pray to the presence of God Almighty. Thanks to his
blessings and graces I am able to finish my review of the journal "Neurobehavioral
Comorbidities in Children with Epilepsy" well.

In the process of compiling this study I get help from various parties, so I
thank you as much as possible. Hopefully all this can give a little happiness and lead
in a better step again.

I am also fully aware that in this task there are shortcomings and far from what
I expect. Therefore, I look forward to constructive criticism and suggestions so that
the study of this journal can be better. Finally I hope that this journal review is useful
for all readers.

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 TABLE OF CONTENTS

Title page

Preface ........................................................................................................................... ii

Table of Contents ............................................................................................... iii

Chapter I Introduction ......................................................................................... 1

1.1 Background ............................................................................................ 1

1.2 Problem Formulation ............................................................................. 1

1.3 Objectives .............................................................................................. 1

1.4 Benefits .................................................................................................. 2

Chapter II Journal Review .................................................................................. 3

2.1 Research Problems ................................................................................. 3

2.2 Research Objectives ............................................................................... 3

2.3 Research Methods .................................................................................. 3

2.4 Research Samples .................................................................................. 3

2.5 Research Results ................................................................................... 4

2.6 Overall Quality ..................................................................................... 5

Conclusion .......................................................................................................... 7

Suggestion ........................................................................................................... 7

References ........................................................................................................... 8

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 CHAPTER I

PRELIMINARY

1.1 Background

Epilepsy or people often call it epilepsy is one disease that can attack anyone,
do not see women or men, children or adults. Basically everyone can experience
epilepsy because everyone has a brain with their respective resurrection thresholds
whether it is resistant or less resistant to the rise of the awakening (Hantoro, 2013: 7)

Epilepsy is one of the major neurological diseases. Basically epilepsy is a

disease of Central Nervous System (CNS) arising from the imbalance of electrical
polarization in the brain. Epilepsy is often associated with physical disability, mental
disability, and severe psychosocial consequences for the person (low education, high
unemployment, social stigma, low self-esteem, unmarried tendencies for the person).

Epilepsy is greater in developing countries with an estimated prevalence of 5.5

cases per 1000 children. The prevalence of associated psychopathology in children
with epilepsy (CWE) is 16-77% and includes cognitive impairment, academic
concern and other neurobehavioral disorders.

1.2 Problem Formulation

1. What is the main strength of research?

2. What are the major weaknesses of the study?

3. Is the study explained in detail?

4. What are suggestions for improving the limitations?

5. What is the main contribution of research?

1.3 Objectives

To examine the journal Neurobehavioral Comorbidities in Children with Epilepsy.

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1.4 Benefits

This journal review is useful to add knowledge insight, especially in health

field for society and health student. Hopefully this journal review can be useful as a
material for intervention as a nursing action as well as health education for parents.

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 CHAPTER II

ALREADY JOURNEY

2.1 Research Problems

The problem discussed in this journal is to study the prevalence, the type and
impact of neurobehavioral disorders in children with and without epilepsy. Due to the
large number of epilepsy events that affect children

2.2 Research objectives

This study aims to determine the prevalence and type of neurobehavioral

disorders in children with active epilepsy using standardized questionnaires. If
epilepsy is not treated quickly it will be fatal.

2.3 Research Methods

In this journal the method used is a prospective case-control study conducted

in the epilepsy outpatient department of a tertiary-level medical college and hospital
located in Mumbai, India over a period of 18 months.

After the Institutional Review Board (IRB) clearance, children agree, aged 5-
12 years with active epilepsy> 6months duration and average registered intellectual
ability and children with developmental disabilities such as autism spectrum
disorders, intellectual disabilities, cerebral palsy, acute symptoms of seizures are
excluded from the study.

2.4 Sample Research

The samples used in this study were children with neurobehavioral disorders.
All cases and controls were given language and behavioral questionnaires in
accordance with the Culture Strength and Difficulty Questionnaire to screen for
neurobehavioral disorders. Strengths and Difficulties Questionnaire (SDQ) is
available in the Indian language and the parent version is given. The questionnaire
focused on 5 domains ie hyperactivity, prosocial behavior, emotional, behavior and
colleagues problem. It screened children with neurobehavioral disorders by measuring

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 total trouble scoring goals as well as individual symptom scores and total impact
scores.

The resulting score by summing the scores of 4 domains except the prosocial
domain. As much as the 0-13 difficulty score is normal, 14-16 is the limit and 17-40 is
abnormal. Supplemental supplements are used to assess the impact neurobehavioral
problems in home life, peer-relationships, classroom learning, recreational activities
and distress as a whole. The five impact scores are then summed to produce a total
impact score from 0-10. A score of 0 is normal, 1 is the limit and 2 is not normal.
Children with a high amount of difficulty symptoms of the score and impact score are
referred to a pediatric development / psychiatrist for further evaluation and
management.

2.5 Research Results

The results of this study are summarized in the following categories: Socio-
demographic results are presented in Table 1. The mean (SD) age of children with
epilepsy (CWE) cases and non-epilepsy control were 8.56 years and 8.6 years with M:
ratio F 1 , 2: 1 and 0.9: 1 respectively. The majority of children from low
socioeconomic classes in both groups. Therefore both age groups, gender and SES are
suitable. developmental delays seen in 13.9% of patients with epilepsy more in the
motor domain (45%). History revealed that 14.4% of epilepsy cases during school had
learned problems, 10.3% had behavioral problems when compared with non-epilepsy
(p <0.001). Furthermore, CWE was more likely to have school irregularities and drop
out, an irregular presence seen at 25.6% CWE compared with 6.1% non-epilepsy (p =
<0.001) and drop out was seen in 17.5% of epilepsy patients compared with 3.9%
non-epilepsy (p <0.001).

Of the 222 cases of epilepsy etiology are metabolic structures in 102 (45.9%),
105 (47.3%) were electroclinical syndrome and 15 (6.7%) others. The structural
lesion, 63/102 (61.7%) had an infective granuloma, 15/102 (14.7%) had brain
asphyxia, 10/102 (9.8%) had focal cortical dysplasia, 7/102 (6, 8%) had a chronic
stroke, 4/102 (3.9%) had neurokutaneus syndrome and 3/102 (2.9%) had insult due to
postnatal infection. Of the 105 electroclinical syndromes, 50/105 (47.6%) had benign
epilepsy with centrotemporal nails, 45/105 (42.8%) had generalized tonic-clonic
epilepsy, 5/105 (4.7%) had a childhood- lack of epilepsy, 2/105 (1.9%) had epipepsy

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 occipital epilepsy ends and 3/105 had epileptic myoclonic epilepsy, nocturnal frontal
lobe epilepsy and early onset of epilepsy occipital childhood respectively. Most of the
epilepsy patients were 89.1% controlled well on monotherapy. Uncontrolled or
refractory epilepsy accounted for a total of 9% (n = 20) of the epilepsy population.
The first drugs selected were sodium valproate at 55.8%, carbamazepine at 18.5%,
phenytoin at 10.3% and the remaining phenobarbital. It is difficult to control epilepsy
also in antiepileptics such as levetiracetam, nitrazepam, vigabatrin, topiramate etc.

2.6 Overall Quality

1. What is the main strength of research?

The main strength of the study is that researchers are able to study the
prevalence, type and impact of neurobehavioral disorders in children with and without
epilepsy.

2. What are the major weaknesses of the study?

In the journal it has been described that the study of its limitations of study
protocols excludes family-related factors (family stress factors, parent / child
relationship and family dynamics) and personality traits that may contribute to the
psychopathology level in children with epilepsy.

3. Is the study explained in detail?

In this study described the most common epilepsy that occurs chronic
neurological disorders that affect children and their families. Lower levels of
education are attained by epilepsy and irregular school attendance and significantly
higher school dropout occurs in patients with epilepsy.

4. What is the main contribution of research?

a. Theoretical

This research is expected to contribute and contribute science and its

application, especially in the field of nursing.

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 b. Practical

The results of the study are expected to be input and provide the correct
standard and module of action for nurses to handle cases of neurobehavioral in
children with epilepsy.

5. What are suggestions for improving the limitations?

Therefore investigators should collaborate with doctors who lead screenings

for behavioral comorbidities, service counseling should be part of multidisciplinary
care in the management of pediatric epilepsy services

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Conclusion

There is a significant prevalence of neurobehavioral disorders in children with

epilepsy. The SDQ is a simple, easy-to-run tool for assessing negligible comorbidity
in busy office practices. behavioral disorders often have an impact on family life,
friendship and learning in the classroom. Unattended emotional problems can lead to
school irregularities, dropouts and poor end-of-life outcomes. Therefore doctors led
screening for behavioral comorbidities, service counseling should be part of
multidisciplinary care in the management of pediatric epilepsy services.

Suggestion

Suggestions from our group, researchers are expected in the future to do

further better research and can determine the appropriate interventions and according
to the problem.

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 BIBLIOGRAPHY

Udani V (2005) Pediatric epilepsy-an Indian perspective. India J Pediatr 72: 309-313

Abubakar A, Kariuki SM, Tumaini JD, Gona J, Katana K, et al. (2015)

Community perceptions of developmental and behavioral problems

experienced by children living with epilepsy on the Kenyan coast: A

qualitative study. Epilepsy Behav 45: 74-78.

(2006) Youth in Mind. SDQ Information for researchers and professionals

about the Strengths & 'L cuOtLes Questionnaires.

Kanner AM (2011) Depression and epilepsy: A bidirectional relation?

Epilepsia 1: 21-27.

Hanssen-Bauer K, Heyerdahl S, Eriksson AS (2007) Mental health

problems in children and adolescents referred to a national epilepsy

center. Epilepsy Behav 10: 255-262.