The epidemiology of the epilepsies in children

Abstract

The epilepsies are a heterogeneous collection of neurological conditions and syndromes characterized by recurrent, unprovoked, paroxysmal seizure activity. There are several types of epileptic seizures and syndromes that are unique to children, including infantile spasms, Lennox-Gastaut syndrome and absence seizures. Febrile seizures and neonatal seizures, while not epilepsy, are relatively common types of seizures in infants and children and are likely markers of risk of later epilepsy. Thus, it is important to consider the epidemiological features of the epilepsies as they occur specifically in infants and children. The purpose of this review is to summarize what is currently known about the epidemiology of the childhood epilepsies and to identify promising areas for further population-based studies. The epilepsies are an important cause of neurological morbidity in children. The average annual rate of new cases (incidence) of epilepsy is approximately 5-7 cases per 10,000 children from birth to age 15 years, and in any given year, about 5 of every 1,000 children will have epilepsy. There is evidence that the incidence of the epilepsies in some populations of children may be decreasing over time, and this possibility merits further investigation. Factors that are known to increase risk of the epilepsies in children include congenital malformations of the central nervous system (CNS), moderate or severe head trauma, CNS infections, certain inherited metabolic conditions, and genetic factors. However, these account for only 25% to 45% of cases, and thus, the etiology of most cases of the epilepsies remains obscure. The paucity of well-controlled etiological studies is due largely to formidable methodological problems in conducting epidemiological studies of the epilepsies. The prognosis for seizure control is generally good, although children with remote symptomatic seizures and those with additional neurological disabilities do less well.

Improved motor development and good long-term glycaemic control with sulfonylurea treatment in a patient with the syndrome of intermediate developmental delay, early-onset generalised epilepsy and neonatal diabetes associated with the V59M mutation in the KCNJ11 gene

“…It is unclear whether the absence seizures are primarily linked to the KCNJ11 gene mutation and represent an intermediate neurological phenotype between intermediate and full DEND syndrome. The multiple foci differ from the bilateral synchronous 3 Hz spike waves commonly seen in absence epilepsy with a genetic origin [23]. An alternative explanation is that it may be attributed to minor lesions of the brain originating from recurrent hypoglycaemia during early phases of life.…”

Risk of epilepsy in type 1 diabetes mellitus: a population-based cohort study

“…The causes of epilepsy can be broadly categorised as structural abnormalities, metabolic disturbances and genetic factors. However, these causes account for only 25-45% of all cases, and there is no clear underlying cause in the remaining population, thus representing forms of idiopathic epilepsy [9].…”

Determinants of Epilepsy in Children and Adolescents (6-19years) in a Tertiary Care Hospital in Kanpur

“…This leads to development of seizures from a particular area of the brain, called as "seizure focus". [2][3][4][5] Recent studies have revealed clinically relevant mechanisms of generalized and localized seizures, among which are inherited abnormalities of ion channels, hippocampal sclerosis, cortical malformations, and dysfunction of glial cells.…”