ADAPTIVE AND MALADAPTIVE BEHAVIOR IN CHILDREN WITH EPILEPTIC ENCEPHALOPATHIES - CORRELATION WITH CEREBRAL GLUCOSE-METABOLISM

In the childhood epileptic encephalopathies mental impairment is commo n and severe, Traditional cognitive assessment is difficult because of the low level of performance, autistic features, and the unpredictabl e effect of seizures. An alternative is to measure adaptive and malada ptive behaviour using instruments administered to the caregivers, Adul ts with different types of dementia have characteristic patterns of co rtical glucose hypometabolism. Thirty-two children were studied using visual and semiquantitative analysis of (18)fluorodeoxyglucose positro n emission tomographic (PET) scans, The Vineland Scales and the Conner s' Questionnaires were used to assess adaptive and maladaptive behavio ur, The mean adaptive behaviour composite score was 37.3+/-15.6; all b ut one subject had a low adaptive level, A profile of relative strengt h in socialisation and weakness in daily living skills emerged, Up to two-thirds of children had abnormal behaviour patterns, particularly a ttention-deficit disorders and hyperactivity, Adaptive and maladaptive behaviour was not related to the presence or absence of focal cortica l PET abnormalities, However, adaptive behaviour scores showed an inve rse correlation with the degree of metabolic abnormality in the fronta l lobes.