Attention, behavioral, and educational adaptation disorders in children with childhood absence epilepsy

Background. In children with epilepsy, the prevalence of comorbid conditions, including neuropsychological disorders, is significantly higher than in the general population of healthy peers. Among the most common comorbid conditions are attention-deficit/hyperactivity disorder, as well as affective and anxiety disorders. According to various studies, these comorbid disturbances exert a substantial impact on cognitive functioning, social adaptation, and quality of life in patients with epilepsy.

Aim. To conduct a comprehensive analysis of attention deficits and behavioral control impairments in children and adolescents with childhood absence epilepsy (CAE) and to determine their contribution to academic maladaptation and quality of life outcomes.

Materials and methods. To achieve the study objective, follow-up data from 70 patients with CAE (including those presenting with active absence seizures, those attending scheduled follow-up consultations, and patients in stable medication-induced remission) and 34 healthy volunteers were analyzed. Academic performance in both the study and control groups was assessed based on final grades in core school subjects and was used as an objective indicator of educational adaptation. Quality of life was evaluated using the Pediatric Quality of Life Inventory 4.0, with age-appropriate versions for children aged 8–12 and 13–18 years. A psychiatrist participated in the study to conduct clinical assessments. Electroencephalographic recordings were performed using the standard “10–20” international electrode placement system.

Results. A high prevalence of attention and behavioral regulation disturbances consistent with attention-deficit/hyperactivity disorder symptomatology was identified in children and adolescents with CAE. Academic performance in patients with CAE was lower compared to healthy peers, and the presence of comorbid attention-deficit/hyperactivity disorder was associated with a tendency toward further decline in educational outcomes. Quality of life in children and adolescents with CAE was predominantly reduced in the psychosocial and school functioning domains; these impairments persisted regardless of therapeutic status, indicating the stable nature of the identified disturbances.

Conclusion. The findings indicate that CAE is associated with a complex pattern of cognitive and behavioral disturbances, including attention deficits, difficulties in behavioral control, and impairments in social-communicative functioning. These alterations are reflected in reduced academic performance and lower quality of life scores. Importantly, even after achieving remission, children may continue to experience difficulties in interpersonal interactions and school integration, suggesting the persistent nature of these impairments and underscoring the need for comprehensive management extending beyond seizure control.