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Gionet S, Lord M, Plourde V. The diagnosis of ADHD in children and adolescents with epilepsy: a scoping review. Child Neuropsychol 2024:1-33. [PMID: 38588042 DOI: 10.1080/09297049.2024.2337954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is often diagnosed in children and adolescents with epilepsy, but clear clinical guidelines on how to make this diagnosis are still lacking. Without these guidelines, there is no consensus between specialists on how to proceed when assessing children with epilepsy for ADHD, which can negatively impact the quality of care being offered to this population. As a first step toward gaining more specific clinical guidelines, this scoping review was aimed at documenting the tools and procedures used to diagnose ADHD in children and adolescents with epilepsy over time and at determining whether the diagnoses were made in accordance with clinical guidelines and recommendations. The literature search was conducted using PsycINFO, PubMed, and CINAHL. Studies were included if conducted with children and adolescents aged between 4 and 18 years with epilepsy being evaluated for ADHD. Studies were clustered according to their publication date and the reported diagnostic procedures were identified. Forty-nine out of 3854 records were included. Results highlight discrepancies between how ADHD was diagnosed in reviewed studies and clinical guidelines or recommendations. Indeed, most studies did not use a multi-method and multi-informant approach when diagnosing ADHD in children with epilepsy, with no improvement over time. Future studies aimed at diagnosing ADHD in children and adolescents should ensure that they are following clinical guidelines and recommendations, in addition to adapting their diagnostic procedures to the presence of any neurological comorbidities, such as epilepsy.
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Affiliation(s)
| | - Maryse Lord
- École de Psychologie, Université de Moncton, Moncton, Canada
| | - Vickie Plourde
- École de Psychologie, Université de Moncton, Moncton, Canada
- Centre de formation médicale du Nouveau-Brunswick, Université de Sherbrooke, Moncton, Canada
- Faculté Saint-Jean, University of Alberta, Edmonton, Canada
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2
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Xiong W, Yang X, Lu L, Ma X, Wang C, Yan B, Zhang Q, Mu J, Li Z, Sander JW, Wang Y, Zhou D. Quality indicators for epilepsy management in China: The development of a tool to assess care and first three-year report. Epilepsy Res 2024; 200:107295. [PMID: 38278099 DOI: 10.1016/j.eplepsyres.2024.107295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/25/2023] [Accepted: 01/05/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVES Epilepsy care in China has expanded considerably in the last decade but still remains largely unknown; we developed an easy-to-use tool to assess its quality. METHODS We adapted the Epilepsy Update Quality Measurement, produced by the American Academy of Neurology (AAN) for use in China: The Quality Indicator for Epilepsy Treatment-China National Action (QUIET-CHINA). This tool incorporates a standardized case report form initially for logging quality indicators for people with epilepsy during in-patient stays. Nine quality indicators covered seizures, drugs, diagnostics, screening for co-morbid conditions, counseling for woman of child bearing age, and a composite indicator was further proposed by total number of interventions performed divided by the total number of people eligible in each indicator. The tool also has an electronic reporting and data feedback system. 96 epilepsy centers in 31 jurisdictions in mainland China have been piloted since 2017. RESULTS Data from 11,600 individuals with epilepsy in the first 3-year study period were analyzed. The median age was 31; 60% were male. The composite indicators were 74%. Seizure freedom rate was less than 25% in all epilepsy types and post-surgical seizure freedom rate was 21%. 90% had seizure type and frequency, antiepileptic drugs recorded, while only 70% with active epilepsy were on regular antiepileptic drugs treatment. Investigations for diagnosis and etiology were performed in around 90% but screening for co-morbid conditions and counseling for women of childbearing potential was 38% and 15% respectively. Severe side effect happened in 2% individuals during the treatment. CONCLUSION The preliminary results of the national action provided some baseline information. Except for an overall improvement, a significant treatment gap still exists, and psychiatric co-morbidities or issues affecting women are not seen as a priority. QUIET-CHINA will be expanded to more and other levels of hospitals, to help narrow the treatment gap and equalize the comprehensive epilepsy care on the national level.
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Affiliation(s)
- Weixi Xiong
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xin Yang
- China National Clinical Research Center for Neurological Diseases, Beijing, China; Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Lu Lu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xudong Ma
- National Health and Family Planning Commission of the People's Republic of China, 100044 Beijing, China.
| | - Caiyun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, China.
| | - Bo Yan
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Qin Zhang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Jie Mu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Zixiao Li
- China National Clinical Research Center for Neurological Diseases, Beijing, China; Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Josemir W Sander
- Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands.
| | - Yongjun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, China; Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; National Health and Family Planning Commission of the People's Republic of China, 100044 Beijing, China.
| | - Dong Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
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Kanhere S, Kacheria A, Goel A. Epilepsy in children: Cognitive development and academic performance. J Pediatr Neurosci 2023. [DOI: 10.4103/jpn.jpn_64_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Azad C, Guglani V, Siddiqui A, Singh S. Psychopathological Aspects in Children with Epilepsy and Its Contributing Factors: A Cross-Sectional Study from India. J Neurosci Rural Pract 2022; 13:301-306. [PMID: 35694050 PMCID: PMC9187380 DOI: 10.1055/s-0042-1743459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background
Children with epilepsy (CWE) are at high risk of psychopathological problems because of neurobiological, social, and treatment factors.
Objectives
This study was conducted to estimate the prevalence of psychopathological problems in CWE and their contributing factors.
Methods
This cross-sectional study was done in pediatric neurology clinic and outpatient department of a government medical college in Northern India. Children between the ages of 4 and 14 years with intelligence quotient > 70 were enrolled; for CWE, the criteria were antiepileptic drugs therapy for more than 6 months and for controls it was being free from any chronic illness. Childhood Psychopathology Measurement Schedule (CPMS) was used for assessing psychopathological problems.
Results
A total of 135 CWE and 70 controls were enrolled, groups were similar in respect of age, gender, socioeconomic status, and family history. CWE group had significantly high mean
±
standard deviation CPMS scores (13.68
±
10.57) as compared with controls (9.75
±
7.97) (
p
< 0.0001). These scores were particularly high in sectors of low intelligence, conduct disorder, psychotic symptoms, and depression. Academic performance was significantly poor in CWE (39%) versus controls (6%) (
p
0.042). Age of onset, duration, type, and etiology of epilepsy had no significant relation with CPMS scores. Polytherapy and treatment with valproate were associated with high CPMS scores (
p
0.005 and 0.045).
Conclusion
Psychopathological problems are frequently associated with epilepsy in children and antiepileptic drug therapy might contribute to it.
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Affiliation(s)
- Chandrika Azad
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Vishal Guglani
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Anam Siddiqui
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Sukhvinder Singh
- Department of General Medicine, Dr. Harvansh Singh Judge Institute of Dental Sciences, Punjab University, Chandigarh, India
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Kirabira J, Jimmy Forry B, Fallen R, Sserwanga B, Rukundo GZ. Perceived stigma and school attendance among children and adolescents with epilepsy in South Western Uganda. Afr Health Sci 2020; 20:376-382. [PMID: 33402925 PMCID: PMC7750070 DOI: 10.4314/ahs.v20i1.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Epilepsy is a neurological disorder that has a high worldwide prevalence with eighty percent of the global burden being in low and middle-income countries. There is a high level of perceived stigma among children and adolescents with epilepsy, which has severe debilitating effects and affects school attendance. Objective To assess the effect of perceived stigma on school attendance patterns among children and adolescents with epilepsy. Methods We conducted a cross sectional study among 191 children and adolescents aged from 6–18 years with epilepsy at one large semi-urban hospital and a small rural health center in SouthWestern Uganda. Epilepsy-related perceived stigma was measured using the adapted Kilifi Stigma Scale of Epilepsy and school attendance patterns were assessed using a piloted investigator-designed questionnaire. Results Children with high-perceived stigma were more likely to have never attended school (13.8%) or started school late (average age 5.7 years) compared to those with low-perceived stigma (average age 4.9 years). Additionally, those with high epilepsy-related perceived stigma repeated classes 2.5 times more compared to those with low-perceived stigma. Conclusion These preliminary findings suggest correlation between high-perceived stigma and disrupted school attendance patterns among children and adolescents with epilepsy, hence the need to address this social challenge.
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Affiliation(s)
| | | | | | | | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology (MUST), P.O. Box 1410, Mbarara, Uganda
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Fleming M, Fitton CA, Steiner MFC, McLay JS, Clark D, King A, Mackay DF, Pell JP. Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766 244 schoolchildren. BMC Public Health 2019; 19:595. [PMID: 31101093 PMCID: PMC6525436 DOI: 10.1186/s12889-019-6888-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/24/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus peers. METHODS Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions. RESULTS Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes. CONCLUSIONS Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare.
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Affiliation(s)
- Michael Fleming
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
| | - Catherine A Fitton
- Department of Child Health, University of Aberdeen, Aberdeen, AB25 2ZG, UK
| | - Markus F C Steiner
- Department of Child Health, University of Aberdeen, Aberdeen, AB25 2ZG, UK
| | - James S McLay
- Department of Child Health, University of Aberdeen, Aberdeen, AB25 2ZG, UK
| | - David Clark
- Information Services Division, Edinburgh, EH12 9EB, UK
| | - Albert King
- ScotXed, Scottish Government, Edinburgh, EH6 6QQ, UK
| | - Daniel F Mackay
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
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Mishra OP, Upadhyay A, Prasad R, Upadhyay SK, Piplani SK. Behavioral problems in Indian children with epilepsy. Indian Pediatr 2016; 54:116-120. [DOI: 10.1007/s13312-017-1012-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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8
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Kampra M, Tzerakis NG, Losidis S, Katsarou E, Voudris K, Mastroyianni S, Mouskou S, Siatouni A, Gatzonis S. Teachers' knowledge about epilepsy in Greece: Information sources and attitudes towards children with epilepsy during school time. Epilepsy Behav 2016; 60:218-224. [PMID: 27240308 DOI: 10.1016/j.yebeh.2016.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/18/2016] [Accepted: 04/03/2016] [Indexed: 12/20/2022]
Abstract
AIM The aim of this study was to explore the sources of information for the educators in Greek primary and secondary schools with regard to epilepsy, first aid to seizures, and pupils' health conditions. METHOD A semistructured anonymous 52-item questionnaire was sent to 100 public primary and secondary Greek schools from all districts. Two thousand thirty-seven teachers were approached; 446 questionnaires returned. The data were analyzed with SPSS20. Also, 70 head teachers were phone-interviewed with an open-ended unstructured questionnaire. The derived data were analyzed using mixed methodology. RESULTS Twenty-two percent of the addressed educational community responded to the questionnaire, mostly women (66.6%). More responses came from urban areas (71.5%). The main source for the teachers to obtain information about epilepsy was found to be personal experience (37.75%) and internet (34.93%). Only a small percentage was referred to courses (6.2%). Eighty point three percent of the educators knew what epilepsy is, and 88.1% had the right view about the nature of the illness. However, 92% of the educators replied that they have not had adequate first aid training. Although 80.3% of the teachers believed that the school personnel are aware of the pupils' medical history, 85.48% of the teachers considered that they are informed about the pupils' condition from the parents/carers, and only 5.53% believed that the information came from the family doctor. Ninety-five point seventy percent of the educators declared a wish for further information and training about epilepsy. CONCLUSION Knowledge and attitudes of the educators towards epilepsy are improved compared with those reported in previous studies conducted in Greece. However, there are still areas of uncertainty which need improvement. The necessity for more information about epilepsy and pupils' medical history along with appropriate training about seizure incidents seems crucial for the Greek educational community. Educational campaigns about epilepsy could improve teachers' knowledge of epilepsy to develop a well-informed and tolerant community. Further research in the field is necessary to provide teachers with accurate information about the illness and the ways to cope with it.
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Affiliation(s)
- Matina Kampra
- Ministry of Health, Aristotelous 17, P.C. 10433, Greece.
| | - Nikolaos G Tzerakis
- Department of Neurosurgery, University Hospital of North Midlands NHS Trust, UK.
| | - Sotiris Losidis
- University of Piraeus, Karaoli Dimitriou 80, P.C. 18534 Piraeus, Greece.
| | - Efstathia Katsarou
- Department of Neurology, Children's Hospital of Athens "P. and A. Kyriakou", Thivon and Levadias str, Athens P.C. 115 27, Greece.
| | - Konstantinos Voudris
- Department of Neurology, Children's Hospital of Athens "P. and A. Kyriakou", Thivon and Levadias str, Athens P.C. 115 27, Greece.
| | - Sotiria Mastroyianni
- Department of Neurology, Children's Hospital of Athens "P. and A. Kyriakou", Thivon and Levadias str, Athens P.C. 115 27, Greece.
| | - Stella Mouskou
- Children's Hospital "P & A Kyriakou", Athens 115 27, Greece.
| | - Anna Siatouni
- Department of Neurosurgery, "Evangelismos" Hospital, National and Kapodistrian University, Greece.
| | - Stylianos Gatzonis
- Department of Neurosurgery, "Evangelismos" Hospital, National and Kapodistrian University, Greece.
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Amudhan S, Gururaj G, Satishchandra P. Epilepsy in India II: Impact, burden, and need for a multisectoral public health response. Ann Indian Acad Neurol 2015; 18:369-81. [PMID: 26713005 PMCID: PMC4683872 DOI: 10.4103/0972-2327.165483] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Epilepsy is a common neurological disorder whose consequences are influenced socially and culturally, especially in India. This review (second of the two part series) was carried out to understand the social impact and economic burden to develop comprehensive program for control and prevention of epilepsy. Epilepsy is known to have adverse effect on education, employment, marriage, and other essential social opportunities. Economic burden associated with epilepsy is very high with treatment and travel costs emerging as an important contributing factor. A vicious cycle between economic burden and poor disease outcome is clear. There is no significant change in the perception, stigma, and discrimination of epilepsy across the country despite improvement in educational and social parameters over the time. The huge treatment gap and poor quality of life is further worsened by the associated comorbidities and conditions. Thus, a multidisciplinary response is needed to address the burden and impact of epilepsy which calls for an integrated and multipronged approach for epilepsy care, prevention, and rehabilitation. Service delivery, capacity building, integration into the existing program, mobilizing public support, and increasing public awareness will be the hallmarks of such an integrated approach in a public health model.
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Affiliation(s)
- Senthil Amudhan
- Department of Epidemiology, Centre for Public Health, Bangalore, Karnataka, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, Centre for Public Health, Bangalore, Karnataka, India
| | - Parthasarathy Satishchandra
- Director/Vice-chancellor and Professor of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Hinton D, Kirk S. Teachers' perspectives of supporting pupils with long-term health conditions in mainstream schools: a narrative review of the literature. HEALTH & SOCIAL CARE IN THE COMMUNITY 2015; 23:107-120. [PMID: 24666555 DOI: 10.1111/hsc.12104] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/07/2014] [Indexed: 06/03/2023]
Abstract
Teachers are supporting an increasing number of pupils with long-term health conditions in mainstream schools. The aim of this literature review was to critically appraise and synthesise research that has examined teachers' perceptions of the key barriers and facilitators to supporting pupils with long-term conditions, teachers' training needs and interventions that aim to improve teachers' knowledge of long-term conditions, and teachers' confidence in supporting children and young people. A narrative literature review was conducted using a systematic search of computerised databases and manual searches of key journals and reference lists to retrieve studies published between 2003 and 2013. Studies were critically appraised and key themes across studies identified. In total, 61 papers from 58 studies were included in the review. The findings suggest that teachers receive little formal training relevant to long-term condition management and are fearful of the risks involved in teaching children and young people with long-term conditions. Communication between families, school and health and social care services appears to be poor. Educational programmes developed in conjunction with and/or delivered by healthcare professionals seem to have the potential to increase teachers' knowledge and confidence. This review suggests that healthcare professionals have an important role to play in supporting teachers in identifying and meeting the needs of pupils with long-term conditions. It is vital that pupils with long-term conditions receive appropriate care and support in schools to ensure their safety and help them to integrate with their peers and achieve their academic potential. Limitations in the current evidence are highlighted and implications for future research are identified.
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Affiliation(s)
- Denise Hinton
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
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Behavioral comorbidity in children and adolescents with epilepsy. J Clin Neurosci 2014; 21:1337-40. [DOI: 10.1016/j.jocn.2013.11.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 07/16/2013] [Accepted: 11/10/2013] [Indexed: 11/21/2022]
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