Children often begin having seizures at a time that is essential to their physical development, as well as the development of basic cognitive, behavioural, and social skills. Although uncontrolled seizures may be the primary problem for these children, they also have a higher risk of emotional, behavioural, social, cognitive/academic, and family problems when compared to healthy peers and children with other chronic health conditions. Problems in any or all of these areas can affect a child's quality of life, including physical, social, and mental well-being and functioning in daily life.
While seizures are usually intermittent, the other issues associated with epilepsy and its treatment may be ongoing. Additional psychosocial issues can arise from your child’s perception of his illness and others’ reactions to his seizures. Therefore, treating seizures is only one component of your child’s epilepsy. The goal of treatment is not only to improve seizure control but to maximize his potential and quality of life.
Researchers who study health-related quality of life discuss five concepts:
- Physical health, including daily functions, general health, severity of physical symptoms, medical side effects, pain, strength, and endurance.
- Mental health, including cognition, emotional well-being, self-esteem, perceived stigma, and the presence of other emotional factors such as anxiety or depression.
- Social health, including participation in social activities and relationships with family and friends.
- Learning/school, including academic success and feeling competent.
- Family, including family closeness, family members’ roles, and family communication.
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Behavioural and emotional problems
Behavioural and emotional difficulties are disproportionately common in children with epilepsy. For example, psychiatric disorders were identified in 34.6% of children with seizures compared to 6.6% in the general population and 11.6% in children with other chronic illnesses. Some of the more common problems include:
- behaviour problems, such as inattentiveness, hyperactivity, and aggression
- emotional problems, such as anxiety, depression, reduced independence (because of seizures and safety issues), and low self-esteem
- social isolation
Factors affecting quality of life
Underlying brain abnormalities, seizures, and seizure treatment can all affect brain functioning. To what degree the child’s learning and physical and psychosocial well-being are affected depends on:
- the presence and extent of an abnormality in the brain and its location
- where in the brain seizures originate
- type, frequency, intensity, and length of the seizures
- the use of anti-epileptic drugs, some of which may alter brain functions and emotions and behaviour
- age of onset
- attitudes and reactions of others towards your child, his epilepsy, and his seizures
- parenting style may also influence how your child responds to his epilepsy