The challenge of neuropsychiatric issues in pediatric epilepsy.

Diagnosis and management of pediatric epilepsy are challenging for a variety of reasons; however, one of the most common yet difficult situations involves treatment of the patient with pediatric epilepsy with coexistent cognitive impairment or psychiatric disturbance. The etiologies and presentations of these comorbidities are myriad, making diagnosis problematic; furthermore, interactions between epilepsy and its treatments and the neuropsychiatric problem and its treatments add another layer of complexity to the management of these patients. Antiepileptic drugs are often blamed for cognitive or behavioral problems in children treated for epilepsy, but the actual contribution to such problems in a particular child can be difficult to ascertain.