Acquired Etiological Factors in 1,785 Epileptic Subjects: Clinical‐Anamnestic Research

Abstract

SUMMARY This study utilizes ciinicai and anamnestic data concerning epileptic subjects (males and females) of ages ranging between 1 month and 21 years. These patients were treated in the Neurology Department of the University of Turin, during the following periods: 1948–1958, 1960–1964, 1970–1974. All possible etiologies of epilepsy were included in the study except those of genetic and tumoral origin. The clinic data, including 68,222 EEG recordings, were considered. An initial sample of 4,947 subjects, aged from 1 month to 21 years, suffering from epileptic seizures was selected, and a final sample of 1,785 cases, with complete clinical and anamnestic data, was analyzed. The results identify an etiological factor in 44% of the cases. The remaining 56% do not show any probable etiology. The distribution of etiologic factors is as follows: (1) birth injuries including neonatal hemorrhagic and hypoxic encephalopathies, prematurity, and kernicterus, 40.66%; (2) postimmuniza‐tion and postinfectious encephalitides, 10.49%; (3) encephalitides and meningoencephalitides of various etiology, 16.75%; (4) craniocerebral trauma, 27.88%; (5) CNS malformations and congenital metabolic encephalopathies, 4.22%. The most interesting finding was the failure to identify any probable etiology in 70% of the subjects with partial epilepsy with complex symptomatology, and in 44% of subjects with generalized seizures (excluding petit mal). These findings can provide a preliminary data base for programs of prevention and for further investigations of the etiology of epilepsy. RÉSUMÉ Cette étude utilise les données cliniques et anamnes‐tiques issues d'une eatude de sujets éapileptiques, des deux sexes compris entre l'âge de un mois à 21 ans. Les patients ont été traites dans le Departmement de Neurologie de l'Université de Turin, péndant les periodes suivantes de: 1948 à 1958, de 1960 à 1964, de 1970 à 1974. Tous les facteurs ètiologiques possibles ont été inclus à l'exception des facteurs génétiques et tumoraux. On a considéré les données cliniques y compris les 68,222 tracés EEG. Un premier échantil‐lon 4,947 patients avec eapilepsie, âgés entre un mois et 21 ans, a éte sélectionne et on a analysé un dernier échantillon de 1,785 cas avec les données cliniques est anamnestiques complètes. Les résultats indiquent la preasence de facteurs étiologiques dans 44% des cas, les restants 56% n'ayant pas d'étiologie evidente. La distribution des facteurs etiologiques est la suivante: (1) trauma a la naissance, comprenant des enceaphalopathies hémorragiques néonatales, et hypoxiques, prématurite et dysmaturitea, et ictere: 40.66%; (2) encéphalites post‐vaccinales et post‐infectieuses: 10.49%; (3) encéphalites et meningoencephalites de differentes etiologies: 16.75%; (4) trauma cranio‐cérébral: 27.88%; (5) malformation du SNC et encéphalopathies meataboliques: 4.22%. La donnée la plus intéressante àété l'impossibilite de retrouver une etiologie probable dans 70% des sujets avec une epilepsie partielle a symptomatologie complexe, et chez 56% des s...

Neurodevelopmental Evaluation in Full-term Newborns with Neonatal Hypoxic Ischemic Encephalopathy (HIE): A Case Control Study

“…From extrapolated information of the epilepsy studies it is found that HIE is related to a high percentage of epilepsies, however, these data vary from study to study ranging from 26% to 46%. 16,17,18,19,20,21,22,23,24 Active epilepsy starting at early age i.e., within 12 month of age if not well controlled and monitored, may affect the rate of developmental skills. Good seizure control probably had facilitated to grow out of the functional limitation among the control population.…”

Bacterial meningitis and epilepsy

“…The majority of unprovoked seizures following bacterial meningitis occur within 5 years of the acute illness (de Graaf, 1974;Bergamini et al, 1977;Sell et al, 1977;Rantakallio et al, 1986;Annegers et al, 1988;Pomeroy et al, 1990;Chang et al, 2004). Unprovoked seizures following bacterial meningitis tend to be recurrent (Rosman et al, 1985;Annegers et al, 1988;Pomeroy et al, 1990).…”

“…In the cohort of survivors of CNS infections in Olmsted County, Minnesota, the ratio of observed to expected (O:E) cases of unprovoked seizures was 6.9 (Annegers et al, 1988). In developed countries, 1-5% of incident cases of epilepsy are presumed to be due to prior CNS infections (de Graaf, 1974;Hauser & Kurland, 1975;Bergamini et al, 1977). The high incidence and prevalence of epilepsy in developing countries has partly been attributed to the endemic CNS infections (Commission on Tropical Diseases of the International League Against Epilepsy, 1994; Preux & Druet-Cabanac, 2005;Mac et al, 2007).…”

Changing Presentation of Seizures with Aging: Clinical and Etiological Factors

“…Prior CNS infections account for 1-5% of epilepsy cases [45][46][47]. The incidence of postinfectious seizures is bimodal with the first peak occurring during childhood and the second peak in the elderly [48].…”