Cognitive, psychological, behavioral, and other medical comorbidities commonly coexist and may affect quality of life even more profoundly than seizures. Identification and treatment of these common symptoms are essential in the holistic care of a child with epilepsy.
Unfortunately, in many patients, neurocognitive delays are a direct result of the underlying cause of epilepsy and are not improved with better seizure control. Conversely, in other patients, very frequent seizures and/or epileptiform discharges may further exacerbate cognitive and behavioral impairment, leading to an epileptic encephalopathy. In these situations, improved seizure control often results in developmental gains, and, thus,
diagnosis and initiation of effective therapy is urgent. Specific syndromes such as West and continuous spike and wave during sleep are commonly associated with epileptic encephalopathy. Other factors that may affect the prevalence and severity of comorbidities include adverse effects of antiseizure medication and other treatments, social stigma and overprotection, and sleep disruption.