Unveiling cognitive disengagement syndrome: A hidden challenge in children with epilepsy.

Background: In our study, we aimed to investigate the prevalence of cognitive disengagement syndrome (CDS) and attention deficit hyperactivity disorder (ADHD) in children with epilepsy and to identify the associated factors.

Method: The study included 62 patients with epilepsy aged 6-18 and 51 healthy controls. Sociodemographic data, epilepsy characteristics, and medication usage were collected. Psychiatric evaluations used various structured interviews and scales.

Results: The mean ages for patients and controls were 9.7 and 9.9 years, respectively. CDS was present in 76 % of patients with epilepsy compared to 26 % of controls (p < 0.01). Patients with epilepsy scored higher on Barkley Child Attention Scale (BCAS) and Turgay DSM-IV Disruptive Behavior Disorders Symptom Screening Scale (T-DSM-IV-S). CDS prevalence was higher in patients without seizure control and those over age 12. Linear regressions demonstrated that age predicted BCAS-sluggish scores (R²: 0.284, p < 0.001) and T-DSM-IV-S hyperactivity scores (R²: 0.065, p: 0.023). The number of antiseizure medications (R²: 0.065, p: 0.023) and the duration of antiseizure medication usage (R²: 0.079, p: 0.014) predicted T-DSM-IV-S oppositional scores.

Conclusion: Our study is the first study in this field. Our study findings highlight the need for further research to understand the pathophysiological mechanisms underlying CDS in epilepsy and to develop targeted interventions.