The impact of early life epilepsy on long term neurological development: a comprehensive study of pediatric patients
Early Life Epilepsy Outcomes
DOI:
https://doi.org/10.69750/dmls.01.09.080Keywords:
Early-life epilepsy, Paediatric neurodevelopment, pharmacological therapy, surgical intervention, alternative therapies, cognitive outcomes, seizure freedomAbstract
Background: Early-onset epilepsy disrupts brain development during critical childhood periods, impacting cognitive, motor, and behavioural functions.
Objectives: This study aimed to evaluate the long-term effects of early-life epilepsy on paediatric neurological development and compare outcomes across pharmacological therapy, surgical interventions, and alternative therapies (e.g., ketogenic diets, neurostimulation).
Methods: A prospective observational study was conducted at different teaching hospitals of Lahore, Pakistan from October 2022 to October 2023. A total of 150 children (aged 0–5 years) with diagnosed epilepsy were enrolled. Patients were categorized into three groups: pharmacological therapy (n=70), surgical intervention (n=40), and alternative therapies (n=40). Standardized tools assessed cognitive (WPPSI), motor (PDMS-2), and behavioural outcomes (CBCL, SRS), along with seizure control and treatment side effects.
Results: Surgical intervention demonstrated the best outcomes, with significant improvements in IQ (92.7 ± 8.9), motor skills (fine: 89.2 ± 9.5, gross: 88.0 ± 9.7), and social interaction (90.4 ± 8.5). Seizure freedom was achieved in 75% of surgical cases compared to 21.4% in pharmacological therapy and 45% in alternative therapies. Behavioural issues and side effects, such as attention deficits (40%) and drowsiness (50%), were most prevalent in the pharmacological group.
Conclusion: Surgical interventions significantly improved developmental outcomes and seizure control in drug-resistant epilepsy cases. Early diagnosis and personalized, targeted treatments are essential to mitigate the neurodevelopmental impact and enhance the quality of life for affected children.
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References
Abgottspon S, Thaqi Q, Steiner L, Slavova N, Grunt S, Steinlin M, et al. Effect of Age at Pediatric Stroke on Long-term Cognitive Outcome. Neurology. 2022;98(7):e721-e9. doi: 10.1212/WNL.0000000000013207
Austelle CW, O'Leary GH, Thompson S, Gruber E, Kahn A, Manett AJ, et al. A Comprehensive Review of Vagus Nerve Stimulation for Depression. Neuromodulation. 2022;25(3):309-15. doi: 10.1111/ner.13528
Gómez-Roig MD, Pascal R, Cahuana MJ, García-Algar O, Sebastiani G, Andreu-Fernández V, et al. Environmental Exposure during Pregnancy: Influence on Prenatal Development and Early Life: A Comprehensive Review. Fetal Diagn Ther. 2021;48(4):245-57. doi: 10.1159/000514884
Jain P, Arya R. Vagus Nerve Stimulation and Seizure Outcomes in Pediatric Refractory Epilepsy. Neurology. 2021;96(22):1041-51. doi: 10.1212/WNL.0000000000012030
Levy AS, Bystrom LL, Brown EC, Fajardo M, Wang S. Responsive neurostimulation for treatment of pediatric refractory epilepsy: A pooled analysis of the literature. Clin Neurol Neurosurg. 2023;234:108012. doi: 10.1016/j.clineuro.2023.108012
Mastrangelo M, Giordo L, Ricciardi G, De Michele M, Toni D, Leuzzi V. Acute ischemic stroke in childhood: a comprehensive review. Eur J Pediatr. 2022;181(1):45-58. doi: 10.1007/s00431-021-04212-x
Mewasingh LD, Chin RFM, Scott RC. Current understanding of febrile seizures and their long-term outcomes. Dev Med Child Neurol. 2020;62(11):1245-9. doi: 10.1111/dmcn.14642
Operto FF, Pastorino GMG, Viggiano A, Dell’Isola GB, et al. Epilepsy and Cognitive Impairment in Childhood and Adolescence: A Mini-Review. Curr Neuropharmacol. 2023;21(8):1646-65. doi: 10.2174/1570159X20666220706102708
Vossler DG, Bainbridge JL, Boggs JG, Novotny EJ, Loddenkemper T, Faught E, et al. Treatment of Refractory Convulsive Status Epilepticus: A Comprehensive Review by the American Epilepsy Society Treatments Committee. Epilepsy Curr. 2020;20(5):245-64. doi: 10.1177/1535759720928269
Raga S, Specchio N, Rheims S, Wilmshurst JM. Developmental and epileptic encephalopathies: recognition and approaches to care. Epileptic Disord. 2021;23(1):40-52. doi: 10.1684/epd.2021.1244
Sorboni SG, Moghaddam HS, Jafarzadeh-Esfehani R, Soleimanpour S. A Comprehensive Review on the Role of the Gut Microbiome in Human Neurological Disorders. Clin Microbiol Rev. 2022;35(1):e00338-20. doi: 10.1128/CMR.00338-20
Bercu MM, Friedman D, Silverberg A, Drees C, Geller EB, Dugan PC, et al. Responsive neurostimulation for refractory epilepsy in the pediatric population: A single-center experience. Epilepsy Behav. 2020;112:107389. doi: 10.1016/j.yebeh.2020.107389
Klepper J, Akman C, Armeno M, Auvin S, Cervenka M, Cross JH, et al. Glut1 Deficiency Syndrome (Glut1DS): State of the art in 2020 and recommendations of the international Glut1DS study group. Epilepsia Open. 2020;5(3):354-65. doi: 10.1002/epi4.12414
Shellhaas RA, Wusthoff CJ, Numis AL, Chu CJ, Massey SL, Abend NS, et al. Early-life epilepsy after acute symptomatic neonatal seizures: A prospective multicenter study. Epilepsia. 2021;62(8):1871-82. doi: 10.1111/epi.16978
Johannessen Landmark C, Potschka H, Auvin S, Wilmshurst JM, Johannessen SI, Kasteleijn-Nolst Trenité D, et al. The role of new medical treatments for the management of developmental and epileptic encephalopathies: Novel concepts and results. Epilepsia. 2021;62(4):857-73. doi: 10.1111/epi.16849
Feng Y-P, Yang T-S, Chung C-H, Chien W-C, Wong C-S. Early childhood general anesthesia exposure associated with later developmental delay: A national population-based cohort study. PLoS One. 2020;15(9):e0238289. doi: 10.1371/journal.pone.0238289
Mahajan A, Stavinoha PL, Rongthong W, Brodin NP, McGovern SL, El Naqa I, et al. Neurocognitive Effects and Necrosis in Childhood Cancer Survivors Treated With Radiation Therapy: A PENTEC Comprehensive Review. Int J Radiat Oncol Biol Phys. 2024;119(2):401-16. doi: 10.1016/j.ijrobp.2020.11.073
Semple BD, Dill LK, O'Brien TJ. Immune Challenges and Seizures: How Do Early Life Insults Influence Epileptogenesis? Front Pharmacol. 2020;11. doi: 10.3389/fphar.2020.00002
Besag FMC, Vasey MJ. Neurocognitive Effects of Antiseizure Medications in Children and Adolescents with Epilepsy. Pediatr Drugs. 2021;23(3):253-86. doi: 10.1007/s40272-021-00448-0
Specchio N, Wirrell EC, Scheffer IE, Nabbout R, Riney K, Samia P, et al. International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: Position paper by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022;63(6):1398-442. doi: 10.1111/epi.17241
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