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The epidemiology of the epilepsies in children
1Department of Biostatistics and Epidemiology, University of Oklahoma College of Public Health, Oklahoma City, Oklahoma 73190, USA. linda.cowan@ouhsc.edu
Insights
Childhood epilepsy affects 5-7 per 10,000 children annually. While some risk factors are known, the causes of most childhood epilepsy cases remain unclear, necessitating further population studies.
Area of Science:
- Neurology
- Pediatrics
- Epidemiology
Background:
- Epilepsies are neurological disorders characterized by recurrent seizures.
- Childhood epilepsy presents unique seizure types and syndromes.
- Febrile and neonatal seizures are common in children and may indicate future epilepsy risk.
Purpose of the Study:
- To review current knowledge on childhood epilepsy epidemiology.
- To identify areas for future population-based research on childhood epilepsy.
Main Methods:
- This is a review article, synthesizing existing epidemiological data.
- Focuses on incidence, prevalence, risk factors, and etiology of childhood epilepsies.
Main Results:
- The incidence of epilepsy is approximately 5-7 cases per 10,000 children (birth to 15 years).
- Approximately 5 in 1,000 children have epilepsy annually.
- Evidence suggests a potential decrease in childhood epilepsy incidence over time.
- Known risk factors (CNS malformations, trauma, infections, metabolic/genetic factors) explain only 25-45% of cases.
Conclusions:
- Childhood epilepsy is a significant cause of neurological morbidity.
- The etiology of most childhood epilepsy cases remains largely unknown.
- Prognosis for seizure control is generally favorable, but poorer for those with remote symptomatic seizures or additional disabilities.
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.