Children with new recent-onset juvenile myoclonic epilepsy (JME) are more likely to have difficulty with executive, attention, and verbal faculties than their healthy peers and are also more likely to use a greater number of academic services, researchers found. Study findings were reported in Pediatric Neurology.
Children between the ages of 8 and 18 years with recent-onset JME (n=41) and first-degree cousin controls (n=70) were enrolled from pediatric neurology clinics in Midwestern medical centers. All patients underwent a neuropsychological assessment battery that tested attention span; executive, verbal, and perceptual abilities; and speed. Additionally, researchers performed a structured review of participants’ need for supportive academic services and reviewed parent reports of both behavior and executive function (Child Behavior Checklist [CBCL] and Behavior Rating Inventory of Executive Function [BRIEF]). The researchers also performed a structured psychiatric interview and diagnosis (Kiddie Schedule for Affective Disorders and Schizophrenia—Present and Lifetime Version [K-SADS]).
Individuals with JME had significantly lower scores compared with controls for attention (P <.05), executive, (P =.001), perceptual (P <.001), speed (P <.05), and verbal (P <.05) areas. A significantly greater proportion of children with JME were also more likely to use a greater number of academic services (47% vs 19%, respectively; P =.002) and to have more parent-reported behavioral problems as well as dysexecutive function with lower competence (P <.001). Those with JME also demonstrated a higher rate of current Axis-I diagnoses, including attention-deficit/hyperactivity disorder, depression, and anxiety vs the control group (54% vs 23%, respectively; P =.001).
Limitations of the study include the small number of patients, its cross-sectional design, and the enrollment of patients from only 3 centers in the Midwest.
“There is likely a subset of children with JME who show minimal neurobehavioral complications, a subset that is heavily burdened, and other subsets that may be more cognitively or behaviorally affected,” the researchers concluded. “This important next step, the clinical (if any) correlates and their longitudinal courses will be important in targeting or personalizing services for youth with JME at the most optimal time.”
Almane DN, Jones JE, McMillan A, et al. The timing, nature and range of neurobehavioral comorbidities in juvenile myoclonic epilepsy [published online March 18, 2019]. Pediatr Neurol. doi: 10.1016/j.pediatrneurol.2019.03.011