OBJECTIVE: To introduce pediatricians to the psychiatric and behavioral disorders that most frequently affect children with epilepsy, qualifying them to diagnose, evaluate risk factors and guide the treatment of these children.
SOURCES OF DATA: MEDLINE (1979 to 2003) and epilepsy clinic at the Neuropediatrics Center, Universidade Federal do Paraná, Brazil.
SUMMARY OF THE FINDINGS: Children with epilepsy are at increased risk for behavioral and emotional problems when compared to children in the general population and to children with other chronic illnesses not involving the central nervous system. Among these problems, the following should be emphasized: oppositional defiant disorder, conduct disorder, depression, anxiety and attention-deficit/hyperactivity disorder. The main risk factors include associated neurological impairment, severe or untreatable epilepsy and family, social or environmental problems. Neurobiological factors associated with epilepsy are also implicated. The usual treatments with specific drugs may be used in children with epilepsy.
CONCLUSIONS: Due to the high incidence of neuropsychiatric disorders in epileptic children, the pediatrician should evaluate the risk factors associated with behavioral, emotional and psychiatric problems. The pediatrician is in a position to, and should, solve most of these difficulties, due to his/her close relationship with the family. In several cases, the associated psychiatric disorders are more harmful to the patient's quality of life than the epilepsy itself.