Novell, Ramon and 2022 Jul 17;19(14):8701. doi: 10.3390/ijerph19148701. "coreDisableEcommerceForElementPurchase": false, The relationship between epilepsy and challenging behaviour in adults with intellectual disabilities is complex.Reference Deb, Bouras and Holt9 Challenging behaviour has been defined as socially unacceptable behaviour that causes distress, harm or disadvantage to the persons themselves or to other people, and usually requires some intervention.Reference Deb, Kwok, Bertelli, Salvador-Carulla, Bradley and Torr10 Challenging behaviour is prevalent among adults with intellectual disabilities, affecting up to around 62%.Reference Smith, Branford, Collacott, Cooper and McGrother11Reference Hemmings, Deb, Chaplin, Hardy and Mukherjee14 More severe forms of challenging behaviour are manifested by a lower proportion (18.730%).Reference Lundqvist13, Reference Deb, Deb, Faruqui, Bodani and Agrawal15 The types of challenging behaviour include aggression, destruction of property, disruptive behaviour, self-injurious behaviour, stereotypy, and sexually inappropriate and harmful behaviours.Reference Hemmings, Deb, Chaplin, Hardy and Mukherjee14, Reference Deb, Bethea, Havercamp, Rifkin, Underwood, Fletcher, Barnhill and Cooper16 Aggression is reported in 1020% of adults with intellectual disabilities.Reference Deb, Bethea, Havercamp, Rifkin, Underwood, Fletcher, Barnhill and Cooper16, Reference Sjgafoos, Elkins, Kerr and Attwood17 The aetiology of challenging behaviour is multifactorial, including medical, psychiatric, psychological, social and environmental factors. 5 Forest plot of self-injurious behaviour score data. However, no such significant intergroup difference was found in five studies.Reference Espie, Pashley, Bonham, Sourindhrin and O'donovan37, Reference Turkistani47, Reference Blickwedel, Vickerstaff, Walker and Hassiotis53, Reference Creaby, Warner, Jamil and Jawad54, Reference Deb and Joyce56 Interestingly, two studiesReference Creaby, Warner, Jamil and Jawad54, Reference van Ool, Snoeijen-Schouwenaars, Tan, Schelhaas, Aldenkamp and Hendriksen72 reported a higher rate of challenging behaviour in the monopharmacy group than in the polypharmacy group, and in one of these studies this intergroup difference was significant.Reference van Ool, Snoeijen-Schouwenaars, Tan, Schelhaas, Aldenkamp and Hendriksen72 Only one study reported the rate of challenging behaviour in various monopharmacy groups (phenytoin, sodium valproate, carbamazepine and lamotrigine monopharmacy) but it made no intergroup comparison.Reference Deb and Joyce56. It helps you go through the pluses and minuses logically. However, it is possible that anti-epileptic polypharmacy made these participants more sedated, thus dampening down the expression of challenging behaviour. In our review, of the total 19 controlled studies, 13Reference Deb, Thomas and Bright12, Reference Deb, Cowie and Richens36, Reference Espie, Pashley, Bonham, Sourindhrin and O'donovan37, Reference Collacott39, Reference Deb40, Reference Matthews, Weston, Baxter, Felce and Kerr43Reference Prasher45, Reference Turkistani47, Reference Fitzgerald, Matson and Barker50Reference Blickwedel, Vickerstaff, Walker and Hassiotis53 did not show any significant intergroup difference in the overall rate of challenging behaviour, 3Reference Gillies, Espie and Montgomery38, Reference Chung and Cassidy42, Reference McGrother, Bhaumik, Thorp, Hauck, Branford and Watson48 showed a significantly higher rate of challenging behaviour in the epilepsy group and 3Reference Matson, Bamburg, Mayville and Khan41, Reference Espie, Watkins, Curtice, Espie, Duncan and Ryan46, Reference Pawar and Akuffo49 showed a higher rate in the non-epilepsy group. Has data issue: false Then, if the information seems important, it ships it to a different section of the brain for long-term storage. One would expect the participants in the polypharmacy group to have more severe epilepsy and, therefore, possibly more challenging behaviour. Epub 2019 Mar 21. van Ool JS, Snoeijen-Schouwenaars FM, Tan IY, Schelhaas HJ, Aldenkamp AP, Hendriksen JGM. Although monopharmacy with anti-epileptic medication is desirable,88 polypharmacy with anti-epileptics is common in intellectual disability populations. Please enable it to take advantage of the complete set of features! Two life-threatening conditions associated with the epilepsies are status epilepticus and sudden unexpected death in epilepsy (SUDEP). Status epilepticus is a potentially life-threatening condition in which a person either has an abnormally prolonged seizure or does not fully regain consciousness between recurring seizures. As a clinician, your knowledge of the individualpatient and judgment about what is appropriate and helpful to them should be used in making clinical decisions. Consider referral for neuropsychological evaluation,especially for adults with additional risk factors for cognitive deficits and for cognitive decline over time: Anti-epileptic drugs: Discuss/review the potential impact of anti-epileptic drugs (AEDs) on cognitive functioning andbehavior. It will be necessary to conduct a much larger randomised controlled trial to recruit a reasonable number of participants in each subgroup to provide adequate power to detect clinically significant intergroup differences. Some people with epilepsy of this kind do have problems with their memory, language, or other kinds of thinking. 2019 Jan;63(1):40-48. doi: 10.1111/jir.12556. Rates of behaviours such as stereotypy, inappropriate sexual behaviour, irritability, hyperactivity, verbal aggression, antisocial behaviours and lethargy. Although some of the epilepsy and ID characteristics seemed to contribute independently to these types of 2022 American Epilepsy Society. Furthermore, DebReference Deb62 has shown that a high proportion of adults with intellectual disabilities who had a clinical diagnosis of primary generalised seizure showed focal epileptiform changes in their EEGs, thus raising the possibility that in many cases these generalised seizures are secondarily generalised from focal seizures. The hippocampus is the ultimate librarian. Sudden unexpected death in epilepsy: a nationwide population-based study, Learning Disability Mortality Review (LeDeR) Programme: Action from Learning. It is the center for outgoing words. To understand words that you hear or read, Wernicke's area steps in. We followed PROSPERO guidelines22 and the PRISMA-P checklist to develop our protocol and search strategy.Reference Moher, Shamseer, Clarke, Ghersi, Liberati and Petticrew23 Five electronic databases Embase, PubMed/MEDLINE, PsycInfo, DARE and ASSIA (ProQuest) were searched for relevant journal articles. The brain is organized so that one area is in charge of each task. Our finding (based on meta-analysis of pooled data from 10 studies) of a significant intergroup difference differs from that of other systematic reviews,Reference Blickwedel, Ali and Hassiotis19Reference van Ool, Snoeijen-Schouwenaars, Schelhaas, Tan, Aldenkamp and Hendriksen21 which found no such difference. Table 3 Challenging behaviours in adults with intellectual disabilities according to different epilepsy variables. It is as if the librarian has gone on strike. It was not necessary for the third review author (S.D.) Data availability is not applicable to this article as no new data were created or analysed in this study. WebEpilepsy is a brain disorder that causes repeated seizures. The risk assessment should be part of the person's overall person-centred support plan and should be monitored and reviewed regularly with the person, their family/caregivers, other relevant professionals and the multidisciplinary team. Behavioral problems; Developmental disability; Mental health; Seizures. Prevalence and patterns of anti-epileptic medication prescribing in the treatment of epilepsy in older adults with intellectual disabilities. Seizures, especially ones that start in the temporal lobe, can cause a major blow to the hippocampus. Epilepsia. Shankar, Rohit Challenging behaviour is defined using a variety of methods in different studies. So if one is affected by seizures, the other can help pick up the slack. Ozer, Mikail Antiepileptic polypharmacy, psychosocial behaviour and locus of control orientation among mentally handicapped adults living in the community, The development of a psychosocial behaviour scale for the assessment of mentally handicapped people, The Behavior Problems Inventory: an instrument for the assessment of self-injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities, Challenging behavior in adults with epilepsy and intellectual disability: an analysis of epilepsy characteristics, Adults with intellectual disabilities: prevalence, incidence and remission of self-injurious behaviour, and related factors, Adults with intellectual disabilities: prevalence, incidence and remission of aggressive behaviour and related factors, DC-LD (Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation), Autism Spectrum Disorders-Comorbidity-Adult Version, Behavior problems: differences among intellectually disabled adults with co-morbid autism spectrum disorders and epilepsy, Reliability and factor structure of the Autism Spectrum Disorders Behavior Problems for Adults (ASD-BPA) with intellectual disabilities and autism, Research Methods and Statistics in Psychology, Bias in meta-analysis detected by a simple, graphical test, Self-injurious behaviour as part of genetic syndromes, The measurement of aggressive behaviour: reflections on the use of the Overt Aggression Scale and the Modified Overt Aggression Scale, Epilepsie als Anfallsleiden und als Psychose-Uber alternative Psychosen paranoider Pragung bei forcierter Normalizierung (Landolt) des Elektoencephalogramms Epileptischer, Some clinical electroencephalographical correlations in epileptic psychosis, Evidence-based guidelines for treating bipolar disorder: revised third edition recommendations from the British Association for Psychopharmacology, Epilepsy, antiepileptic drugs, and aggression: an evidence-based review, Levetiracetam for the treatment of epilepsy among adults with intellectual disabilities, National Institute for health and Care Excellence, The Epilepsies: The Diagnosis and Management of the Epilepsies in Adults and Children in Primary and Secondary Care (NICE Clinical Guideline CG137), Handbook of Evidence-Based Practices in Intellectual and Developmental Disabilities. The aim of the current systematic review and meta-analysis is to identify the rates and types of challenging behaviour in adults with intellectual disabilities who have epilepsy (the epilepsy group) and compare them with rates and types in adults with intellectual disabilities who do not have epilepsy (the non-epilepsy group) to determine whether epilepsy is a risk factor for developing challenging behaviour in this population. An odds ratio was calculated for the studies that presented the proportion of participants in each group displaying challenging behaviour. Mulryan, Niamh 2 Forest plot of total challenging behaviour score data from 16 studies. O'Dwyer, Mire WebEpilepsy is a complex set of brain disorders with epileptic seizures being the quintessential defining element. According to both SIGN 50 and Cochrane risk-of-bias assessments most studies appeared to be of moderate to poor quality. Plekanchuk, Vladislava S. Redina, Olga E. 2019 Jun;139(6):519-525. doi: 10.1111/ane.13085. "coreDisableSocialShare": false, and Your attention may drift much sooner than before. Broca's area is located just above the front of the temporal lobe. inappropriate treatment and/or environment) factors for challenging behaviour in general. Bertelli, Marco 1. Another problem is that none of these specific behavioural types was defined using any standardised criteria (such as the Modified Overt Aggression Scale for rating aggression)Reference Deb, Deb, Faruqui, Bodani and Agrawal15, Reference Ratey and Gutheil82 but were based on single-item scoring. The self-injurious behaviour meta-analysis also showed a statistically significant higher rate in the epilepsy group compared with the non-epilepsy group, with a very small effect size of 0.28, but the heterogeneity score was high, albeit below 60% (I 2=54%). WebWhen seizures happen, they can have two different effects on thinking: A seizure can disrupt the area of the brain in charge of a particular function. Bibliographies of potential studies were screened to identify articles that required acquisition of the full text. 5 Forest plot of self-injurious behaviour score data.NEP, no epilepsy; EP, epilepsy. WebBehavioral disorders are common in people with epilepsy and intellectual disability. 5) and on stereotypy from three (Fig. We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Perera, Bhathika In discussions with patientsand families, the clinician should emphasize the balance of all risks and the goal of controlling seizures. 8600 Rockville Pike The most common types that cause most concern and are most difficult to manage are aggression (verbal or physical aggression towards other people or property) and self-injurious behaviour. The quality of the overall systematic review was assessed using AMSTAR 2 criteria (see Appendix 3; supplementary material).Reference Shea, Reeves, Wells, Thuku, Hamel and Moran35. ABC-C, Aberrant Behaviour Checklist-Community version; ABS-II, Adaptive Behaviour Scale Part II; ANOVA, analysis of variance; ANCOVA, analysis of covariance; ASD-CA, Autism Spectrum Disorders-Comorbidity-Adult version battery; DAS, Disability Assessment Schedule; DASH-II, Diagnostic Assessment for the Severely Handicapped-Part 2; MANOVA, multivariate analysis of variance; MANCOVA, multivariate analysis of covariance; PAA, Profile of Abilities and Adjustment schedule; PBS, Psychosocial Behaviour Scale; SIB, self-injurious behaviour. This strange-looking thing is responsible for receiving new information and storing it. However, to counteract the problem with study heterogeneity we used sensitivity analyses. Compared with previous systematic reviews this review included data for a much higher number of participants (Table 4). Fig. Purpose Cognition and language difficulties are frequently reported in both children and adults with epilepsy. While most children outgrow absence seizures, some: Must take government site. Disclaimer: AES is providing this document without representations or warranties of any kind and for information only, and it is not intended tosuggest how a specific patient should receive medical treatment. Classification of intellectual disability according to domains of adaptive functioning and between-domains discrepancy in adults with epilepsy. Total loading time: 0 A descriptive survey of long-term residents with epilepsy and intellectual disability at the Chalfont Centre: is there a relationship between maladaptive behaviour and magnetic resonance imaging findings? Buried deep inside the temporal lobe is the hippocampus (hip-o-CAM-pus). Whether you've had one or many seizures, you probably want to know how seizures affect the way you think. Majid, Madiha Depression Screening may consider Neurological Disorders Depression Inventory for Epilepsy (NDDI-E; Gilliam etal. Some people say their personality has changed after having seizures for many years. You may not be able to organize your thoughts or your actions in the best way. De Vreese, Luc Pieter 1 The flowchart of the paper selection process. Only quantitative studies in English were searched. and S.D. All authors contributed to manuscript writing and authorised the final version of the manuscript. Sleep: Assess sleep behaviors/environment (lifestyle factors) to assure adequate sleep for optimizing seizurecontrol and cognitive and behavioral function.
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