Psychosocial problems affect cognitive and behavioral development in epilepsy patients. Psychological and psychiatric disorders can contribute to academic and cognitive problems. For example, depression is associated with memory impairments, sometimes mimicking dementia. Also, ongoing academic problems in children can cause an apparent progression of cognitive impairment, as healthy peers develop at an accelerated rate.

Among the factors that contribute to impairment are:70

• physical disability that prevents participation in activities
• side effects of medications
• fatigue
• feeling different from peers
• impaired self-esteem
• depression or anxiety about illness
• worries about the future
• lack of independence
• loss of sense of control
• multiple hospitalizations and visits to health care professionals
• restriction of social activities
• increased stressors on parents and children

These psychosocial problems may have a greater impact on patients with epilepsy than was demonstrated in the past.129,130 A study matched children with epilepsy to those with asthma and assessed them with regard to physical, psychological, social, and school functioning.131 Children with epilepsy showed greater impairments in the psychological, social, and school categories, whereas asthmatics had a more compromised quality of life in the physical domain.

Adapted from: Devinsky O and Tarulli A. Progressive cognitive and behavioral changes in epilepsy. In: Devinsky O and Westbrook LE, eds. Epilepsy and Developmental Disabilities. Boston: Butterworth-Heinemann; 2001;133–149.
With permission from Elsevier (www.elsevier.com).
Reviewed and revised May 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.