Pediatric medicine update: new treatments and psychosocial comorbidity in children and adolescents with epilepsy

Children and adolescents with epilepsy have an increased risk of psychiatric problems, including ADHD, anxiety, depression, ASD, and increased risk for suicide. New antiseizure medications have both positive and negative behavioral effects. Most reviews have found that most psychotropic drugs do not have an adverse effect on seizure control, even in those with intractable epilepsy. This presentation aims to elucidate some of the complexities regarding the behavioral and cognitive comorbidities of childhood epilepsy. We will cover the recognition and treatment of behavioral and emotional problems in children with epilepsy. We will focus on behavioral effects of antiseizure medications and seizure surgery, and on the role of psychopharmacology in the treatment of psychiatric problems in children with epilepsy. We will emphasize evaluation and treatment of children with developmental and epileptic encephalopathies because these are the children with more severe behavioral and cognitive problems. Using a case-based approach, we will present on the roles that child and adolescent psychiatrists play in the evaluation and management of pediatric patients with epilepsy. We will review the contribution that child and adolescent psychiatry can make in a comprehensive epilepsy clinic. We will discuss potential future treatments for those children with early-onset epilepsy, ASD, and intellectual disability. We will review the roles that a child and adolescent psychiatrist provides in the care and management of children with epilepsy. We will emphasize recognition of behavioral and cognitive problems in children with epilepsy. We will cover both positive and negative effects of the newer antiseizure medications and the outcome data on seizure surgery in children for seizure control and cognitive and behavioral long-term effects. This presentation will equip child and adolescent psychiatrists with the knowledge needed to confidently treat and manage behavioral and emotional conditions in children with epilepsy and will help the child and adolescent psychiatrist communicate this information to patients and their families.