Behavior problems in children before first recognized seizures

Objective. It is not known when behavior problems begin in children with ep ilepsy. The purposes of this study were to: 1) describe the rates of behavi or problems in children before their first recognized seizure, 2) determine the differences in behavior problems between children with a first recogni zed seizure and their healthy siblings, and 3) identify the seizure variabl es early in the course of the condition that are associated with behavior p roblems before the first recognized seizure. Methods. The sample was 224 children (4-14 years old) with a first recogniz ed seizure and their 135 healthy siblings. As part of a larger study, compu ter-assisted structured telephone interviews were conducted with mothers to measure child and sibling behavior problems. Behavior problems were measur ed using the Child Behavior Checklist. Frequencies, t tests, correlational analysis, and multiple regression were used to analyze data. Results. Higher than expected rates of behavior problems in the 6 months be fore the first recognized seizure were found in the total seizure sample, w ith 32.1% being in the clinical or at-risk range. Rates were highest in chi ldren who had previous events that were probably seizures, with 39.5% in th e clinical or at-risk range. Children with seizures had significantly highe r Total, Internalizing, Attention, Thought, and Somatic Complaints problem scores than their nearest-in-age healthy siblings. Within the seizure sampl e, variables significantly associated with behavior problems after adjustin g for research site, child sex, child age, and socioeconomic status (as rep resented by primary caregiver's education) were interactions of previously unrecognized seizures with gender and epilepsy syndrome/type of seizures. Conclusions. Children with previously unrecognized seizures are already at increased risk for behavior problems at the time of their first recognized seizure. These findings are consistent with the hypothesis that in some chi ldren, epilepsy is a pervasive condition that includes both seizures and be havioral problems.