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 2023 to October 2024. 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.
Downloads
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: Technology at the Neural Interface. 2022;25(3):309-15.doi: https://doi.org/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 Diagnosis and Therapy. 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. Clinical Neurology and Neurosurgery. 2023;234:108012.doi: https://doi.org/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. European Journal of Pediatrics. 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. Developmental Medicine & Child Neurology. 2020;62(11):1245-9.doi: https://doi.org/10.1111/dmcn.14642
Operto FF, Pastorino GMG, Viggiano A, Dell, apos, Isola GB, et al. Epilepsy and Cognitive Impairment in Childhood and Adolescence: A Mini-Review. Current Neuropharmacology. 2023;21(8):1646-65.doi: https://doi.org/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 Currents. 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 Disorders. 2021;23(1):40-52.doi: https://doi.org/10.1684/epd.2021.1244
Sorboni Shokufeh G, Moghaddam Hanieh S, Jafarzadeh-Esfehani R, Soleimanpour S. A Comprehensive Review on the Role of the Gut Microbiome in Human Neurological Disorders. Clinical Microbiology Reviews. 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 & Behavior. 2020;112:107389.doi: https://doi.org/10.1016/j.yebeh.2020.107389
Klepper J, Akman C, Armeno M, Auvin S, Cervenka M, Cross HJ, 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: https://doi.org/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: https://doi.org/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: https://doi.org/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. International Journal of Radiation Oncology*Biology*Physics. 2024;119(2):401-16.doi: https://doi.org/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? Frontiers in Pharmacology. 2020;11.doi: 10.3389/fphar.2020.00002
Besag FMC, Vasey MJ. Neurocognitive Effects of Antiseizure Medications in Children and Adolescents with Epilepsy. Pediatric 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: https://doi.org/10.1111/epi.17241
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
©The Author(s) . Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/public domain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.