Neuropsychiatric comorbidities in childhood absence epilepsy

This Practice Point commentary discusses a cross-sectional study by Caplan et al. that identified frequent comorbidities associated with childhood absence epilepsy (CAE). The authors found that children with CAE exhibited subtle cognitive deficits (25%), linguistic difficulties (43%), and psychiatric diagnoses (61%)-in particular, attention deficit hyperactivity disorder and anxiety. The severity of the comorbidities was related to epilepsy duration, seizure frequency, and antiepileptic drug treatment. Only 23% of the children in the study were receiving interventions to treat the comorbidities. Although epilepsy associated with CAE seems to have a 'benign' outcome in most cases, a subpopulation of patients with CAE will continue to experience seizures and associated comorbidities, perhaps accounting for the poor outcomes of such patients in adulthood. The diagnosis and treatment of the CAE syndrome might be enhanced by use of a multidisciplinary approach involving an epileptologist, cognitive-developmental physicians, and child psychiatrists.