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Occurrence and outcome of epilepsy in children younger than 2 years
1Department of Pediatrics, University of Oulu, Oulu, Finland.
Insights
Early-onset epilepsy in children aged 28 days to 2 years has a good outcome in cryptogenic cases, with most achieving remission and normal mental development. Symptomatic epilepsy, however, often persists and is associated with cognitive impairments.
Area of Science:
- Pediatric Neurology
- Epileptology
- Child Development
Background:
- Epilepsy onset in early childhood presents unique diagnostic and management challenges.
- Understanding the long-term outcomes of infantile-onset epilepsy is crucial for clinical practice and parental guidance.
Purpose of the Study:
- To determine the incidence of epilepsy in children between 28 days and 2 years of age.
- To analyze the outcomes, including remission rates and cognitive development, for children with early-onset epilepsy.
Main Methods:
- A population-based cohort study included children born between 1976 and 1986.
- Follow-up data were collected via medical records and questionnaires to assess epilepsy status and developmental milestones.
Main Results:
- The cumulative incidence of epilepsy by age 2 years was 1.3 per 1000 children.
- Children with cryptogenic epilepsy showed significantly higher remission rates (97.0%) and normal mental development (93.9%) compared to those with symptomatic epilepsy.
- Epilepsy type (symptomatic vs. cryptogenic) was the sole predictor of persistent epilepsy.
Conclusions:
- The long-term outcome for children with epilepsy starting between 28 days and 2 years is strongly influenced by the underlying etiology.
- Cryptogenic epilepsy in this age group generally has a favorable prognosis with good remission and cognitive outcomes.
Objective:
To analyze the occurrence of epilepsy between the ages of 28 days and 2 years and the outcome of children with the onset of epilepsy at that age.
Study Design:
The study included all children who were born between January 1, 1976, and December 31, 1986, in an area with a mean annual live birth rate of 5027 and who were treated for epilepsy at that age. Follow-up data were gathered from medical records and/or with a questionnaire.
Results:
By age 2 years, 72 children had epilepsy, giving a cumulative incidence rate of 1.3 cases per 1000 children (95% CI, 1.0-1.6). Thirty-two (97.0%) of the 33 children with cryptogenic epilepsy were without medication at the time of the last visit and had been in remission for a mean period of 13.0 years (range, 7.4-19.7 years), in contrast to only 5 (15.6%) of the 32 children with symptomatic epilepsy (difference, 81.3%; 95% CI of the difference, 63.0%-91.3%; P <.0001). In the logistic regression model, the type of the epilepsy (symptomatic/cryptogenic) was the only variable that explained the persistence of epilepsy during the follow-up (P <.05). Thirty-one (93.9%) of the 33 children with cryptogenic epilepsy were mentally normal, as opposed to only 3 (9.4%) of the 32 children with symptomatic epilepsy (difference 84. 6%; 95% CI of the difference, 66.3%-93.4%; P <.0001).
Conclusion:
The outcome of children whose epilepsy starts between the ages of 28 days and 2 years is determined by the underlying brain disease, and the outcome is good in cryptogenic cases.