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BACKGROUND: Epilepsy is a chronic neurologic disorder characterized by abnormal functioning of brain networks, making it a complex research topic. Recent advancements in neuroimaging technology offer an effective approach to unraveling the intricacies of the human brain. Within different types of epilepsy, there is growing recognition regarding ongoing changes in the default mode network (DMN). However, little is known about the shared and distinct alterations of static functional connectivity (sFC) and dynamic functional connectivity (dFC) in DMN among epileptic subtypes, especially in children with epilepsy. METHODS: Here, 110 children with epilepsy at a single center, including idiopathic generalized epilepsy (IGE), frontal lobe epilepsy (FLE), temporal lobe epilepsy (TLE), and parietal lobe epilepsy (PLE), as well as 84 healthy controls (HC) underwent resting-state functional magnetic resonance imaging (fMRI) scan. We investigated both sFC and dFC between groups of the DMN. RESULTS: Decreased static and dynamic connectivity within the DMN subsystem were shared by all subtypes. In each epilepsy subtype, children with epilepsy displayed significant and distinct patterns of DMN connectivity compared to the control group: the IGE group showed reduced interhemispheric connectivity, the FLE group consistently demonstrated disturbances in frontal region connectivity, the TLE group exhibited significant disruptions in hippocampal connectivity, and the PLE group displayed a notable decrease in parietal-temporal connectivity within the DMN. Some state-specific FC disruptions (decreased dFC) were observed in each epilepsy subtype that cannot detect by sFC. To determine their uniqueness within specific subtypes, bootstrapping methods were employed and found the significant results (IGE: between PCC and bilateral precuneus, FLE: between right middle frontal gyrus and bilateral middle temporal gyrus, TLE: between left Hippocampus and right fusiform, PLE: between left angular and cingulate cortex). Furthermore, only children with IGE exhibited dynamic features associated with clinical variables. CONCLUSIONS: Our findings highlight both shared and distinct FC alterations within the DMN in children with different types of epilepsy. Furthermore, our work provides a novel perspective on the functional alterations in the DMN of pediatric patients, suggesting that combined sFC and dFC analysis can provide valuable insights for deepening our understanding of the neuronal mechanism underlying epilepsy in children.

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Epilepsy affects nearly 50 million people worldwide. Epilepsy can affect the quality of life of both the child and the caregiver leaving them unable to function in other areas of life. This quality of life is highly dependent on treatment adherence and how individuals feel about taking their medication. In our study, we aimed to investigate the frequency of medication adherence and the quality of life of caregivers of children with epilepsy. For this purpose, we conducted a cross-sectional survey at the Abha Maternity and Children's Hospital. We enrolled 133 consecutive participants and asked them to complete a questionnaire. The results showed that 37.6% of the participants forgot to take their medications, 9.8% of the participants reported that they were sometimes careless about giving their children medications and sometimes stopped giving them when the children were feeling better, 15.8% of the participants indicated that they sometimes stopped giving the medication when they felt that their children were getting worse when they took the medication., and 26.3% of the participants agreed that they only administered the medication when the children were sick. It was also found that the quality of life of the caregivers decreased when they forgot to give their children the medication and the quality of life of the caregivers increased when they continued to take the medication. In conclusion, quality of life increases as adherence to treatment increases, indicating that more intervention programs are needed to improve the adherence of epilepsy patients.

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Objective: The aim of this study was to establish a population pharmacokinetic (PPK) model of valproic acid (VPA) in pediatric patients with epilepsy in southern China, and provide guidance for individualized medication of VPA therapy. Methods: A total of 376 VPA steady-state trough concentrations were collected from 103 epileptic pediatric patients. The PPK parameter values for VPA were calculated by using the nonlinear mixed-effects modeling (NONMEM) method, and a one-compartment model with first-order absorption and elimination processes was applied. Covariates included demographic information, concomitant medications and selected gene polymorphisms. Goodness-of-fit (GOF), bootstrap analysis, and visual predictive check (VPC) were used for model evaluation. In addition, we used Monte Carlo simulations to propose dose recommendations for different subgroup patients. Results: A significant effect of the patient age and ABCB1 genotypes was observed on the VPA oral clearance (CL/F) in the final PPK model. Compared with patients with the ABCB1 rs3789243 AA genotype, CL/F in patients with GG and AG genotypes was increased by 8% and reduced by 4.7%, respectively. The GOF plots indicated the satisfactory predictive performance of the final model, and the evaluation by bootstrap and VPC showed that a stable model had been developed. A table of individualized dosing regimens involving age and ABCB1 genotype was constructed based on the final PPK model. Conclusion: This study quantitatively investigated the effects of patient age and ABCB1 rs3789243 variants on the pharmacokinetic variability of VPA. The PPK models could be beneficial to individual dose optimization in epileptic children on VPA therapy.

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Objective: A number of studies in adults and children with generalized tonic-clonic seizure (GTCS) have reported the alterations in morphometry, functional activity, and functional connectivity (FC) in the thalamus. However, the neural mechanisms underlying the alterations in the thalamus of patients with GTCS are not well understood, particularly in children. The aim of the current study was to explore the temporal properties of functional pathways connecting thalamus in children with GTCS. Methods: Here, we recruited 24 children with GTCS and 36 age-matched healthy controls. Static and dynamic FC approaches were used to evaluate alterations in the temporal variability of thalamo-cortical networks in children with GTCS. The dynamic effective connectivity (dEC) method was also used to evaluate the directions of the fluctuations in effective connectivity. In addition, the relationships between the dynamic properties and clinical features were assessed. Results: The static FC analysis presented significantly decreased connectivity patterns between the bilateral thalamus and between the thalamus and right inferior temporal gyrus. The dynamic connectivity analysis found decreased FC variability in the thalamo-cortical network of children with epilepsy. Dynamic EC analyses identified increased connectivity variability from the frontal gyrus to the bilateral thalamus, and decreased connectivity variability from the right thalamus to the left thalamus and from the right thalamus to the right superior parietal lobe. In addition, correlation analysis revealed that both static FC and connectivity temporal variability in the thalamo-cortical network related to the clinical features (epilepsy duration and epilepsy onset time). Significance: Our findings of both increased and decreased connectivity variability in the thalamo-cortical network imply a dynamic restructuring of the functional pathways connecting the thalamus in children with GTCS. These alterations in static and temporal dynamic pathways connecting the bilateral thalamus may extend our understanding of the neural mechanisms underlying the GTCS in children.

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OBJECTIVE: Generalized tonic-clonic seizures (GTCS) is a group of epileptic disorders characterized by widespread generalized spike-and-waves discharges along with unresponsiveness and convulsions. Abnormal connectivity in the DMN is the common findings in children with generalized epilepsy. However, the neural mechanisms underlying the altered brain connectivity of DMN in children with GTCS remain unclear. The aim of the current study was to explore the temporal properties of functional connectivity states by dynamic functional connectivity (dFC) within the DMN of GTCS children. METHODS: We collected resting-state functional MRI data from 22 GTCS children and 29 age-matched healthy controls. Sliding window approach and k-mean clustering analysis were applied to analyze the dFC and identify transient states of the DMN. Furthermore, the relationship between the dynamic properties and clinical features was assessed. RESULTS: The dFC analyses identified two reoccurring states: a more frequent and weak connected state (State 1) and a less frequent and strong connected state (State 2). Relative to the normal control, GTCS children spent more time in State 1 showing weak connections and spent less time in State 2 showing strong connections. Dynamic functional network connectivity strength within the DMN showed both increase and decrease in patient group. In addition, the changes of dynamic metric were found to be correlated with epilepsy duration. SIGNIFICANT: Our findings imply abnormal interactions and the state dynamics in DMN of the children with GTCS. These disruptions of temporal dynamic in DMN may provide significance for understanding the neural mechanism underlying the GTCS in children and suggest that dFC method can be considered as a valuable tool in children with epilepsy.

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BACKGROUND: Epilepsy, the most common neurological disorder in children, may present with many psychiatric comorbidities, the most common of which is depression. AIM OF THE WORK: We evaluated the frequency of depressive symptoms in epileptic children, with regard to the possible association between depression and their demographic data or seizure-related variables. PATIENTS AND METHODS: This cohort study was conducted on 80 children (6-13 years old) diagnosed as idiopathic epilepsy and were regularly recruiting the pediatric neurology clinic at Minya University Children Hospital. The Structured Birleson Depression Scale Questionnaire was used for assessment of presence of depressive symptoms, and Quality Of Life in Epilepsy (QOLIE-31) score was used to assess quality of life in those patients. RESULTS: Depressive symptoms were found in 37.5% of enrolled patients. There were statistically significant differences between the patients with depressive symptoms and the other group regarding age (p=0.001), residence (p=0.006) and past history of mood disorders (p=0.03). Sleep disturbance was the highest predictor of depression in cases with depressive symptoms, detected in 90% of cases, followed by appetite disturbance in 86.6% of cases, while delusions and hallucinations were the lowest, detected in only 10% of cases. Both duration of epilepsy and frequency of seizures were significantly higher in cases with depressive symptoms than the other group (p=0.001) for both. QOLIE score was significantly lower in cases with depressive symptoms than the other group (p= 0.01 for all). CONCLUSION: Depressive symptoms are common in epileptic children, and it is often challenging and underestimated. It should be screened during the management of such children. Early diagnosis and more comprehensive package of care for depression in epileptic children will enable them to have a better quality of life.

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BACKGROUND: To observe the relationship between Tumor Necrosis Factor-alpha (TNF-α) and Neuropeptide Y (NPY) expression and neurological function score in epileptic children. METHODS: Fifty-four epileptic children diagnosed and treated in Xuzhou Children's Hospital, China from Feb 2017 to Mar 2018 were collected and included in a research group (RG), while 30 healthy children who underwent physical examination at the same time were included in the control group (CG). ELISA was used to detect the expression of TNF-α and NPY in the serum of children in the two groups, and those before treatment were compared. The National Institute of Health stroke scale (NIHSS) and Hamilton Anxiety (HAMA) scores before and after treatment were observed, and Pearson correlation was used to analyze the relationship between the expression levels of TNF-α and NPY in the serum as well as NIHSS and HAMA scores. RESULTS: The expression levels of TNF-α and NPY in the serum of children in the RG were significantly higher than those in the CG (P<0.001). The expression level of TNF-α was positively correlated with the NIHSS and HAMA scores (r=0.748, P<0.001) (r=0.772, P<0.001). The expression level of NPY was positively correlated with the NIHSS and HAMA scores (r=0.768, P<0.001) (r=0.643, P<0.001). CONCLUSION: TNF-α and NPY are highly expressed in epileptic children and are positively correlated with neurological function score.

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PURPOSE: This study was conducted to explore the influence of genetic variations on responsiveness to valproic acid (VPA) monotherapy among Chinese children with epilepsy. METHODS: One hundred and forty epileptic children taking VPA as monotherapy were enrolled, and at least one-year follow-up was obtained to assess the therapeutic outcome. Twenty-seven single nucleotide polymorphisms (SNPs) within twelve candidate genes correlated with the metabolic enzymes, transporters and targets of VPA were genotyped. The effects of selected polymorphisms on VPA efficacy were identified by binary logistic regression analysis adjusting for potential confounders. RESULTS: SCN2A rs2304016 (A > G) AG genotype was more common among the VPA-resistant patients in comparison with the VPA-responsive patients (OR = 3.18, 95 % CI = 1.10-9.14, P = 0.032), and in subgroup of focal seizure, lower frequency of VPA resistance was found in epileptic children with SCN1A rs2298771 AG genotype than those with AA genotype (OR = 0.11, 95 % CI = 0.01-0.91, P = 0.040). CONCLUSIONS: Our study indicated that SCN2A rs2304016 and SCN1A rs2298771 polymorphisms might be associated with the response to VPA monotherapy in Chinese epileptic children. Further and larger researches are required to validate these results.

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INTRODUCTION: Generalized tonic-clonic seizure (GTCS) is a condition that is characterized by generalized spike-wave discharge in bilateral cerebral hemispheres during the seizure. Although previous neuroimaging studies revealed functional abnormalities in the brain activities of children with GTCS, the topological alterations in whole-brain networks remain poorly understood. METHODS: The present study used graph theory to investigate the topological organization of functional networks in 13 GTCS children and 30 age-matched healthy controls. RESULTS: We found that both groups exhibited a small-world topology of the functional network. However, children with GTCS showed a significant decrease in nodal local efficiency and clustering coefficient in some key nodes compared with the controls. The connections within the default mode network (DMN) were decreased significantly, and the internetwork connections were increased significantly. The altered topological properties may be an effect of chronic epilepsy. As a result, the optimal topological organization of the functional network was disrupted in the patient group. Notably, clustering coefficient and nodal local efficiency in the bilateral temporal pole of the middle temporal gyrus negatively correlated with the epilepsy duration. CONCLUSION: These results suggest that the bilateral temporal pole plays an important role in reflecting the effect of chronic epilepsy on the topological properties in GTCS children. The present study demonstrated a disrupted topological organization in children with GTCS. These findings provide new insight into our understanding of this disorder.

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BACKGROUND: Low levels of AEDs can be secondary drug-drug interactions or related to irregular intake due to poor treatment adherence. This latter behavior is highly suspected in ambulatory pediatric epileptic patients when controls of AEDs are subtherapeutic. However, it cannot be considered for inpatients during long periods of hospitalization. A few isolated case reports have documented persistent low levels (PLL) of AEDs in hospitalized epileptic children, but no population study has currently been reported. OBJECTIVE: The aim of this study was to document the incidence of PLL of the most common AEDs - phenytoin (PHT), phenobarbital (PHB), valproic acid (VA), and carbamazepine (CBZ) - in pediatric epileptic in- and outpatients (PEP). METHODS: 21,040 plasma levels of the aforementioned AEDs from 3279 PEP were retrospectively analyzed. Plasma levels of AEDs were measured by an automated method using trademarked commercial kits with their corresponding quality control programs. Randomized samples were also controlled by HPLC methods. Only cases with more than 3 controls were included in the study. RESULTS: A high rate of PLL of PHT was detected in in- (71.7%) and outpatients (74.1%), while PLL of PHB, VA, and CBZ were detected in a lower proportion. Rates of PLL of PHT were similar in in- and outpatients. PLL of PHB was more commonly observed in outpatients while PLL of VA and CBZ were more frequently seen in inpatients. In some hospitalized patients receiving polytherapy, PLL of at least one AED were documented during a long time. DISCUSSION: Treatment non-adherence could be present in part of the outpatients, but cannot explain the PLL observed in a group of inpatients as described here. The recently described "pharmacokinetic hypothesis" of pharmaco-resistant epilepsy should be addressed in cases with AEDs-PLL, particularly in hospitalized cases. Perhaps, instead of stopping the subtherapeutic medication, the increasing doses of this AED and/or administration of inhibitors of CYP and P-glycoprotein, could help to achieve its therapeutic range, allowing a better pharmacologic effect and avoiding the development of more severe complications, such as status epilepticus or SUDEP.

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Valproic acid (VPA) is a first-line anti-epileptic drug that is used in the treatment of generalized and partial seizures. Gene variants had been proved to influence the pharmacokinetics (PK) of VPA and contribute to its inter-individual variability (IIV). The aim of this study was to systematically investigate the effects of candidate gene variants (CYPs, UGTs, ABC transporters, and nuclear receptors) on VPA PK in Chinese children with epilepsy. A total of 1065 VPA serum trough concentrations at steady state were collected from 264 epileptic pediatric patients aged 3 months to 16 years. The population pharmacokinetic (PPK) model was developed using a nonlinear mixed effects modelling (NONMEM) approach. For the final PPK model, the oral clearance (CL/F) of VPA was estimated to be 0.259 L/h with IIV of 13.3%. The estimates generated by NONMEM indicated that the VPA CL/F was significantly influenced by patient body weight (increased by an exponent of 0.662), co-administration with carbamazepine (increased CL/F by 22%), and daily dose of VPA (increased by an exponent of 0.22). CL/F in patients with the LEPR rs1137101 variant (668 AG and GG genotypes) was much lower than in patients with the AA genotype (17.8% and 22.6% lower, respectively). However, none of the CYPs or UGTs gene variants was found to influence the PK of VPA in this study. Evaluation by bootstrap and normalized prediction distribution error (NPDE) showed that the final model was stable. The predictive performance was evaluated by goodness-of-fit (GOF) plots and visual predictive checks (VPC), and the results indicated satisfactory precision. Our model suggests a correlation between VPA CL/F and LEPR rs1137101 variants, which might be beneficial in the context of individual dose optimization.

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Increasing literature has shown the usefulness of a dimensional approach to mental disorders, particularly when exploring subjects exposed to traumatic experiences such as a severe illness in one's child. Recent evidence suggests an increased vulnerability in subjects with autism spectrum symptoms to develop post-traumatic stress symptoms. The aim of the present study was to evaluate the presence of adult autism subthreshold spectrum in a sample of parents of children with epilepsy and its impact on post-traumatic stress spectrum symptoms in the same study sample. Results revealed noteworthy correlations between post-traumatic stress symptoms and adult autism subthreshold spectrum (AdAS Spectrum) only in the subgroup of the fathers. In particular, were evidenced correlations between AdAS Spectrum domain of rumination and narrow interests and some TALS-SR nuclear domains: reaction to traumatic events, reexperiencing and arousal. These findings corroborate the hypothesis that subthreshold autistic features may influence the possible psychopathological reaction to trauma.

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OBJECTIVES: Epilepsy is one of the most common paediatric neurological disorders. Lack of awareness regarding epilepsy among the general population influences the lives of epileptic children. Misconceptions and misinformation about epilepsy in children should be identified and corrected. The aim of this study was to assess the knowledge and attitudes towards epilepsy in families of epileptic children and families of normal children in Almadinah Almunawwarah, KSA. METHODS: A cross-sectional study was conducted at Maternity and Children's Hospital from March 2015 to December 2015. A self-administered questionnaire was designed to collect data from the participant families. RESULTS: Of 168 participants, 150 completed the questionnaire. These included 64 families of epileptic children and 86 families of normal children. Of all the responding families, 67 families (44.7%) thought that epilepsy was related to Jinn. Logistic regression analysis showed that this belief was dependent on the family education level (p = 0.004) and to the area of residence, either urban or rural (p = 0.04). In families of epileptic children, the link of epilepsy to Jinn was related to clinical factors, such as the type of epilepsy (p = 0.023), disease duration (p = 0.039), and duration of treatment (p = 0.028). CONCLUSIONS: Our community still has misconceptions regarding epilepsy, even among families of epileptic children. Knowledge and attitudes toward epilepsy must be corrected. Planned programs and campaigns should be conducted in the form of mass society education.

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OBJECTIVE: Epilepsy is a chronic neurological disease. Evidence has indicated that epilepsy has an impact on mental and physical health of children. The present study aimed to determine the effectiveness of attribution retraining on health enhancement of epileptic children. MATERIALS & METHODS: This was an experimental study with a pre-test and a post-test design with a control group. Thirty students with epilepsy (11 female and 19 male students) were selected in convenience from Iranian Epilepsy Association. They were assigned to experimental and control groups and their mothers completed Child Health Questionnaire (CHQ-PF.28) before and after the intervention. The experimental group attended to eleven sessions (each session 45 minutes; twice a week). Subjects were trained by attribution retraining program, but control group was not. Multivariate analysis of covariance (MANCOVA) was used for analyzing the data. RESULTS: Health (both psychosocial and physical) of experimental group enhanced significantly after the intervention sessions compared to control group. CONCLUSION: Attribution retraining is an effective intervention to enhance the psychosocial and physical health of epileptic children.

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OBJECTIVE: Approximately one third of epileptic children are resistant to anticonvulsant drugs. This study evaluates the effectiveness, safety, and tolerability of pregabalin as adjunctive therapy in epileptic children relative to Zonisamide. MATERIALS & METHODS: From April 2012 to November 2012,121 children were referred to Mofid Children's Hospital with intractable epilepsy and enrolled in the study. The patients were divided into two groups (A and B) randomly. Group A was treated with Zonisamide and group B was treated with Pregabalin in addition to prior medication. We assessed seizure frequency and severity during a 4-week interval from the beginning of the drug treatment and compared the efficacy of each in these two groups. RESULTS: Group A consists of 61 patients, 26 (42.6%) girls, and35 (57.4%) boys with an age range from 1.5 months-14 years (mean, 73.9± 44.04 months). Group B consists of 60 patients, 31(51.7%) girls, 29 (48.3%) boys with an age range from 6 months-16 years (mean, 71±42.9 months). Age, gender, seizure onset, seizure frequency, seizure type, and previous antiepileptic medications showed that there was no significant difference between the groups (P>0.05). Zonisamide and pregabalin reduced more than 50% of seizure intensity in 40.2%; 45.8% of patients also had a seizure frequency decline between35.8-44.4%, respectively and there was no significant superiority between these two novel anticonvulsants (P>0.05). CONCLUSION: In this survey both pregabalin and Zonisamide were impressive for seizure control in children with intractable epilepsy and well sustained with mild complications that were completely reversible.

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OBJECTIVES: The numerous antiepileptic drug (AED) withdrawal studies published in the last 40 years have relied mainly on heterogeneous study groups. There is still no general agreement on the criteria to predict safe discontinuation. The goal of this study was to assess the outcome of AED withdrawal in epileptic children. MATERIALS AND METHODS: Three hundred and eight children with epilepsy were enrolled, and these patients followed at least 1 year after drug withdrawal. Time to seizure relapse and predictive factors were analyzed by survival methods. RESULTS: Among the 308 patients, 179 (58.1%) were boys and 129 (41.9%) were girls and the mean age at the seizure onset was 60.41 ± 36.54 months (2-144 months). The recurrence occurred in 73 (23.7%) patients. Mental retardation, history of febrile seizure, etiological of epilepsy, abnormal first electroencephalogram (EEG), abnormal neuroimaging findings, and total number of AED before remission were significantly associated with relapse risk according to univariate analysis. In the multivariate analysis, abnormal first EEG and number of AED before remission (polytherapy) were the risk factors influencing seizure recurrence. CONCLUSIONS: In our study, recurrence rate was 23.7% in children and most occurred during the 1(st) year. The potential risk factors of recurrence are history of febrile seizure, mental retardation, etiological of epilepsy, abnormal first EEG, abnormal neuroimaging findings, and total number of AED before remission. However, we found abnormal first EEG and polytherapy as risk factors of recurrence in multivariate analysis.

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PURPOSE: This study investigated the need for information and social support in parents of children with epilepsy. METHODS: A total of 119 parents of children with epilepsy were recruited and asked to fill out questionnaires. RESULTS: Of 119 parents, two-third reported that they received full and sufficient information about their child's disease and its management but one-third felt the information was insufficient and incomplete. Most parents (62.2%) felt at loss when their child had a seizure, either at home or at school. They wanted information on the causes of seizures, adequate steps deal with seizure and steps they should take to become adequate and supportive parents for their children. However, most parents were reluctant to disclose the disease or to receive support from outsiders. CONCLUSION: Regardless of the fact that most parents received sufficient information about the management of epilepsy, they felt at a loss when their child had a seizure attack. Therefore nurses should give specific instruction on seizure management and assess the needs of parents on a regular basis.

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PURPOSE: The purpose of this study is to assess and compare the stress of mothers and fathers in families with epileptic children, and to assess contributing factors to their stress. METHODS: We used a family stress survey with 35 questionnaires to obtain data concerning the parents' perceived stress. Data were analyzed with SPSS 8.0 program using Pearson correlation coefficient, oneway ANOVA, and multiple range test. RESULTS: The parents' stress level seemed not so high and there was no significant difference in stress level between mothers and fathers. There was no significant correlation between most demographic variables of the parents and parents' stress level. But the time of bringing epileptic children correlates positively with the stress level. Oneway ANOVA showed the differences of parents' stress level according to the education institution, seizure type, number of antiepileptic drugs, and the combined disabilities of the sufferer. CONCLUSION: The results of present study indicate that the stress level in the families with epileptic children may be influenced by some treatment-related characteristics of epileptic children such as seizure type, number of antiepileptic drugs, combined disabilities and the raising method of hospital expenses.

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OBJECTIVES: We conducted this study to investigate the parental attitude toward their children wiht idiopathic convulsive disorder and to compare it with that of parents with healthy children. METHODS: The parents of children with convulsive disorder were recruited from the outpatient department of pediatric neurology in Seoul National University Hospital in Korea. We excluded patients with mental retardation, pervasive developmental disorder and overt organic brain pathology. The parents of normal students were chosen as control group. Children's sex, age, achievement and socioeconomic status were matched. The author interviewed all the children and their parents and obtained the developmental history and family information. 'Questionnaire for adult's attitude toward children with convulsive disorder' was used to obtain the data about the ideas about epileptic children and their family members from both parents of epileptic and normal children. RESULTS: First, parents of epileptic children worried too much about the possibility that convulsion made serious damage on physical status of patients. 25% of them believed that even single convulsion could lead to sudden death. Second, as the causes of convulsive disorder, the parents chose brain damage brain pathology worries of children mode of parenting worries of family genetic origin in order of frequency. 40% of them had false concepts that the way of rearing and childen's psychological problems might cause the convulsive disorder. Third, according to the answers of parents of epileptic children, more than 60% of children with convulsive disorder had cognitive, emotional, behavioral and learning problems. Fourth, parents of epileptic children reported behavioral change, emotional disturbance and attentional problems as result of adverse effect of medication. Fifth, Many parents of epileptic children had difficulties in explaining the disease and reasons of taking medication to patients. Sixth, Many parents of epileptic children worried about marriage and employment and reported the several limitations of social lives of parents and patients. The parents of healthy children had more tendency to believe that the convulsive disorder could be one of genetic diseases than parents of epileptic children. They chose the brain pathology-genetic originmode of parenting-brain damage-worries of children-worries of family as the causes of convulsive disorder in order of frequency. The parents of healthy children had overcare about the limitations of children's social activity and difficulties of parents and family members of epileptic children. CONCLUSION: This study revealed the parents of epileptic children had some overcares and misbelieves about their children's disorder. Also, the parents of healthy children had more distorted ideas about the causes of the convulsive disorder and its impact on epileptic children and their family members. So the mental health professionals should prepare and conduct the comprehensive and effective educational programs for the parents and public members.

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PURPOSE: Epilepsy, a typical chronic disease, may cause a high level of psychosocial difficulties for all family members, including stigmatization, stress, marital problems, poor self esteem and restriction of social activities. The present study focuses on how children with epilepsy affect their families' functioning. METHODS: The subjects were 30 parents of epileptic children. The Feetham Family Function Survey(FFFS) was used to obtain data concerning the parents' perceived family functioning. Data were analyzed with SPSS 8.0 program using Pearson correlation coefficient, Oneway ANOVA, and multiple range test(Scheffe test). RESULTS: The results of analysis showed slightly low score of the amount of the activity, high importance score and discrepant score, which mean a low satisfaction level. There was no significant correlation between most demographic variables of the family and the family functioning. Oneway ANOVA showed the differences of the discrepant score according to the number of the antiepileptic drugs, the frequency of the seizure, the combined disabilities, and the ways in which families with epileptic children raised money for hospital expenses. CONCLUSION: The results of this study indicate that the expected level and the important score might be higher than the achieved level of the family functioning, which indicates the low satisfaction in the families with epileptic children. The results also suggest that the discrepant score in the families with epileptic children may be influenced by some treatment-related characteristics of the epileptic children such as the frequency of the seizure, the number of the antiepileptic drugs, the combined disabilities and the ways in which families with epileptic children raised money for hospital expenses.

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