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Epilepsy in children: prevalence, disability, and handicap
1Department of Pediatric Neurology, University of Turku, Finland.
Insights
Children with epilepsy, even without other neurological deficits, face a significantly higher risk of handicaps. This study highlights that epilepsy alone increases handicap risk by over 21 times compared to controls.
Area of Science:
- Neurology
- Pediatrics
- Public Health
Background:
- Epilepsy's impact on quality of life, particularly handicaps in children without co-occurring neurological issues, is poorly understood.
- Understanding these specific challenges is crucial for targeted interventions and support.
Purpose of the Study:
- To investigate the prevalence of disabilities and handicaps in children with epilepsy, focusing on those without additional neurological deficits.
- To compare handicap occurrence in children with epilepsy only against matched controls.
Main Methods:
- A population-based study of children aged 4-15 years, identifying epilepsy cases and assessing neurological deficits and handicaps.
- Matched control group comparison to determine the specific risk associated with epilepsy.
Main Results:
- Epilepsy prevalence was 0.68%. Neurological comorbidity was high (39.9%), with intellectual disability, speech, and learning disorders being most common.
- Children with epilepsy only (no other neurological deficits) showed a 21.7-fold increased risk of handicaps compared to controls (20.7% vs 0.9%).
- Orientation and social integration handicaps were significantly more prevalent in children with epilepsy only. Communication disability, situational disability, and family economic status predicted handicaps.
Conclusions:
- Epilepsy, even in isolation, poses a substantial risk for handicaps in children, impacting social integration and orientation.
- Identifying predictors like communication and situational disabilities is key for early intervention in children with epilepsy.
Abstract:
Little is known about the handicapping effect of epilepsy without other neurological deficits on an epileptic individual's life. The purpose of this study was to collect information on the occurrence of disabilities and handicaps in an unselected population sample of children, 4-15 years of age, and to compare the results with matched controls. The prevalence of epilepsy in the study population was 0.68% (143/21, 104). Time elapsed from last seizure was at least 1 year in 62.1% of the cases. There was marked neurologic comorbidity in the children with epilepsy; an accessory neurological deficit was found in 39.9%, the most frequent neurological impairments being mental retardation (31.4%), speech disorders (27.5%), and specific learning disorders (23.1%). A handicap was experienced in 20.7% of children with epilepsy only; i.e., with no other neurologic impairments, compared to 0.9% of matched controls. This means a 21.7-fold (95% CI, 6.3-74.5) risk of the occurrence of a handicap in children with epilepsy compared to controls. Orientation and social integration handicaps were significantly more frequent in children with epilepsy only compared to controls. Occurrence of communication disability, situational disability, or satisfactory to poor economic status of the family were the independent predictors of the occurrence of a handicap in children with epilepsy only.