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Diagnostic challenges between sluggish cognitive tempo and childhood absence epilepsy

Objective: Sluggish cognitive tempo (SCT) is characterized by daydreaming, appearing confused, and sluggishness. Although SCT and childhood absence epilepsy (CAE) are different clinical entities, there are diagnostic challenges between SCT and CAE due to some overlapping symptoms. To define valuable clinical parameters for distinguishing between SCT and CAE in children. Methods: We designed two study groups, including 40 children ( mean age, 9.81 ) with SCT, 27 children (mean age, 10,50 ) with CAE, and an age-matched control group of 41 healthy children (mean age, 9.41) The Barkley Child Attention Survey (BCAS) was used to assess "sluggishness" and “daydreaming” symptoms in children from two study groups and a control group. Results: SCT-total and SCT-sluggish scores were significantly higher in children with SCT than in those with CAE. However, SCT-daydreamy symptoms were greater but not significantly higher in children with SCT than in those with CAE. Both the cases with SCT and those with CAE had significantly higher SCT symptoms than controls (all p<0,001, in Table 1.). ROC Curve analyses revealed that BCAS had satisfactory discrimination power between the cases with CAE and controls [AUC=0.92 (95%CI = 0.87–0.98)], but it had low power for distinguishing the cases with SCT from those with CAE [AUC=0.67 (95%CI = 0.52–0.81)]. Conclusion. These findings highlight that SCT and CAE can be confused with each other in clinical settings. ‘Sluggishness’ symptoms seem to be important clues in terms of distinguishing and recognizing SCT and CAE symptomatologically by child psychiatrists and child neurologists.
Keywords: sluggish cognitive tempo, childhood absence epilepsy