Investigando a freqüência escolar de crianças com epilepsia

The childhood epilepsy is a chronic disease that can have an impact in various spheres of life of the child, including academic performance and school attendance. This study aimed to describe and compare the school attendance of children with epilepsy who attend mainstream and special schools. Participants were 56 children aged between 7 and 14 years who attended regular or special schools located in two Brazilian cities of medium size. To collect the information we used two instruments: Data sheet of identification and characterization of the child and Data sheet to record the attendance school. The results showed that children in special schools had higher rates of absenteeism compared to students in regular schools. Additionally, we observed that these children use more drugs and have implications on health more severe than children in regular schools. Thus, it is the childhood epilepsy as a disease complex that brings substantial effects on various areas of children’s lives by reinforcing the need for studies that might expand the knowledge to and the experiences associated with the education of these children.A epilepsia infantil é uma doença crônica que pode trazer impacto em diversas esferas da vida da criança, inclusive no desempenho acadêmico e na freqüência as aulas. Desta forma, o presente estudo teve como objetivo descrever e comparar a freqüência escolar de crianças com epilepsia que freqüentavam escolas regulares e especiais. Participaram do estudo 56 crianças com idade entre 7 e 14 anos que freqüentavam escolas regulares ou especiais localizadas em duas cidades brasileiras de médio porte. Para a coleta de informações foram utilizados dois instrumentos: Formulário de identificação e caracterização da criança e Formulário para registro de freqüência às aulas. Os resultados mostraram que as crianças das escolas especiais apresentaram maior índice de absenteísmo quando comparadas aos alunos das escolas regulares. Adicionalmente, observou-se que estas crianças utilizam maior número de medicamentos e apresentam comprometimentos na saúde mais severos do que as crianças das escolas regulares. Assim, considera-se a epilepsia infantil como uma enfermidade complexa que traz repercussões importantes em diversos âmbitos da vida da criança reforçando a necessidade de estudos que possam ampliar o conhecimento a e as experiências ligadas à escolarização destas crianças. Palavras-chave: Escola. Epilepsia Infantil. Freqüência escolar. Absenteísmo. Escolarização

Medication-taking behavior and drug self regulation in people with epilepsy

OBJECTIVE: To study the most important characteristics of antiepileptic drug (AED) taking behavior in epileptic people. METHODS: In a crosssectional study, 45 consecutively seen patients answered a standardized questionnaire including questions about drug intake behavior. RESULTS: Both genders were equally represented (22M x 23F). The mean age was 30.2 years. No specific characteristic were presented in all patients. The self-reported non-use of the drug at any moment one week before (self-reported non-adherence) was 40.0%. Patients took the drug more than once in most cases (75.0%), and the only precipitating factor of seizures more frequently avoided was alcohol intake (66.7%). Forty-four percent said to be afraid of becoming addicted to the medicine, 61.4% reduced or stopped the medicine just to see what would happen, and 47.7% changed the prescription with the same purpose. There is no relationship among socio-demographic, behavior aspects or treatment characteristics, and self-reported non-adherence. CONCLUSIONS: Several patient's aspects do not seem to be strongly correlated with self-reported adherence. Nevertheless, drug self-regulation is probably related to the drug-intake behavior, and it is important for the physician to understand this parallel influence on treatment for a more realistic approac

Impacto da epilepsia no processo de escolarização de crianças e adolescentes Impact of epilepsy on the schooling of children and adolescent

O objetivo deste trabalho foi identificar o número de crianças com epilepsia matriculadas em escolas públicas regulares e especiais de duas cidades brasileiras e verificar se variáveis associadas à epilepsia estão correlacionadas ao tipo de escola, que as crianças frequentavam. Participaram do estudo 56 crianças e adolescentes com idade entre 7 e 14 anos e utilizaram-se para a coleta de dados dois instrumentos: Formulário de identificação da criança e Classificação de Crises de Engel. Os dados obtidos foram analisados descritiva e comparativamente, utilizando-se o Software Minitab - Versão 12.1, por meio dos testes t de Student, Mann-Whitney, qui-quadrado, além de regressão logística. Os resultados indicaram que as crianças das escolas especiais quando comparadas às crianças das escolas regulares apresentavam gravidade da doença e frequência de crises mais elevadas, início mais precoce e duração da epilepsia mais longa, além de utilizarem maior número de medicamentos. Conclui-se que variáveis orgânicas da epilepsia podem interferir no processo de escolarização de crianças epilépticas. Entretanto, são necessários novos estudos visando investigar dificuldades que poderiam interferir no rendimento acadêmico causando alterações no aprendizado de crianças com epilepsia.The objective of this paper was to identify the number of children with epilepsy enrolled in regular and special public schools in two medium size Brazilian cities and verify which disease variables are correlated to the type of school the children attended to. Study participants were 56 children and adolescents aged between 7 and 14 years; two instruments were used: forms of identification of children and Engel's seizure classification. Obtained data were analyzed, using the Minitab Software - Version 12.1, by means of the Student t, Mann-Whitney and chi-square tests and logistic regression. The results indicate that children from special schools presented cases that were more sever, with greater seizure frequency, earlier epilepsy onset, and longer episodes of epilepsy; they also used a greater number of anticonvulsants. The conclusion indicated that organic epilepsy variables can affect the schooling process for children with epilepsy. However, further studies are needed to investigate difficulties that might interfere with academic performance and that may affect learning in children with epilepsy

Beliefs and Attitudes about Childhood Epilepsy among School Teachers in Two Cities of Southeast Brazil

Childhood epilepsy is a chronic neurological disorder associated with profound psychosocial limitations epileptic children's routine. Lack of information and inappropriate beliefs are still the factors that most contribute to the stigma and discrimination. This study aimed at characterizing teacher's beliefs and attitudes at regular and special schools in two cities of southeastern Brazil where students with epilepsy studied. Fifty-six teachers of public regular schools and specialized educational institutions for children with disabilities from two cities of Southeast Brazil who had epileptic children in their classroom completed the Brazilian version of The Epilepsy Beliefs and Attitudes Scale: Adult Version and answered a data sheet about sociodemographic characteristics. The results showed that no significant differences (P≤0.05) have been found between the beliefs and attitudes of teachers in mainstream and special schools but both schoolteachers had more inappropriate beliefs and attitudes than appropriate ones against childhood epilepsy. These findings raise an important issue, providing us with the knowledge that epilepsy is still a condition which is surrounded by wrong beliefs. Also, educational programs could help reduce the gaps in knowledge about how such disease has been perceived worldwide

Mental health of children and adolescents with epilepsy: analysis of clinical and neuropsichological aspects

Epilepsy compromises the development of cognitive and social skills and represents a risk of psychiatric comorbidity. Objective: To compare psychopathological symptoms in children with epilepsy and in a healthy group, and to correlate the results with neuropsychological and clinical variables. Method: Forty five children with idiopathic epilepsy and sixty five healthy controls underwent neuropsychological evaluation and their caregivers replied to a psychopathology questionnaire (Child Behavior Checklist – CBCL). Results: There were significant differences in CBCL, with poorer results showed mainly by patients with epilepsy. There was no significant association between any psychopathological symptom and disease duration or amount of antiepileptic drugs used. There was positive correlation between intelligence quocient and CBCL on items such as sluggish cognitive tempo, aggressive behavior, attention problems and activities and a negative relation between academic achievement, conduct and rule-breaking behavior. Conclusion: Children with epilepsy had the worse results in the psychopathology evaluation. Certain psychopathological variables are related to the cognitive profile, with no relation to clinical variables

Sialorrhea in children with cerebral palsy,

Abstract Objective: To review the literature on sialorrhea in children with cerebral palsy. Source of data: Non-systematic review using the keywords "sialorrhea" and "child" carried out in the PubMed®, LILACS®, and SciELO® databases during July 2015. A total of 458 articles were obtained, of which 158 were analyzed as they were associated with sialorrhea in children; 70 had content related to sialorrhea in cerebral palsy or the assessment and treatment of sialorrhea in other neurological disorders, which were also assessed. Data synthesis: The prevalence of sialorrhea is between 10% and 58% in cerebral palsy and has clinical and social consequences. It is caused by oral motor dysfunction, dysphagia, and intraoral sensitivity disorder. The severity and impact of sialorrhea are assessed through objective or subjective methods. Several types of therapeutic management are described: training of sensory awareness and oral motor skills, drug therapy, botulinum toxin injection, and surgical treatment. Conclusions: The most effective treatment that addresses the cause of sialorrhea in children with cerebral palsy is training of sensory awareness and oral motor skills, performed by a speech therapist. Botulinum toxin injection and the use of anticholinergics have a transient effect and are adjuvant to speech therapy; they should be considered in cases of moderate to severe sialorrhea or respiratory complications. Atropine sulfate is inexpensive and appears to have good clinical response combined with good safety profile. The use of trihexyphenidyl for the treatment of sialorrhea can be considered in dyskinetic forms of cerebral palsy or in selected cases

Sialorrhea in children with cerebral palsy,

Abstract Objective: To review the literature on sialorrhea in children with cerebral palsy. Source of data: Non-systematic review using the keywords "sialorrhea" and "child" carried out in the PubMed®, LILACS®, and SciELO® databases during July 2015. A total of 458 articles were obtained, of which 158 were analyzed as they were associated with sialorrhea in children; 70 had content related to sialorrhea in cerebral palsy or the assessment and treatment of sialorrhea in other neurological disorders, which were also assessed. Data synthesis: The prevalence of sialorrhea is between 10% and 58% in cerebral palsy and has clinical and social consequences. It is caused by oral motor dysfunction, dysphagia, and intraoral sensitivity disorder. The severity and impact of sialorrhea are assessed through objective or subjective methods. Several types of therapeutic management are described: training of sensory awareness and oral motor skills, drug therapy, botulinum toxin injection, and surgical treatment. Conclusions: The most effective treatment that addresses the cause of sialorrhea in children with cerebral palsy is training of sensory awareness and oral motor skills, performed by a speech therapist. Botulinum toxin injection and the use of anticholinergics have a transient effect and are adjuvant to speech therapy; they should be considered in cases of moderate to severe sialorrhea or respiratory complications. Atropine sulfate is inexpensive and appears to have good clinical response combined with good safety profile. The use of trihexyphenidyl for the treatment of sialorrhea can be considered in dyskinetic forms of cerebral palsy or in selected cases