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Seizure disorders in Down syndrome
S M Pueschel1, S Louis, P McKnight
1Department of Pediatrics, Rhode Island Hospital, Providence.
Insights
Seizure disorders affect 8.1% of individuals with Down syndrome, with onset typically occurring in infancy or early adulthood. Common seizure types vary by age group, impacting management strategies.
Area of Science:
- Neurology
- Genetics
- Developmental Pediatrics
Background:
- Down syndrome is associated with an increased risk of neurological complications, including epilepsy.
- Understanding the specific seizure profiles in this population is crucial for effective management.
Purpose of the Study:
- To determine the prevalence and characteristics of seizure disorders in individuals with Down syndrome.
- To describe the age of onset, seizure types, and patterns in this cohort.
Main Methods:
- Retrospective cohort study of 405 individuals with Down syndrome (aged 6 months to 45 years).
- Data collected via parental questionnaires and medical record review.
Main Results:
- Prevalence of seizure disorder was 8.1% (33 out of 405 individuals).
- A bimodal age of seizure onset was observed: 40% before age 1, and 40% in the third decade.
- Infantile spasms and tonic-clonic seizures with myoclonus were common in younger individuals; partial seizures and tonic-clonic seizures were more frequent in older individuals.
Conclusions:
- Seizure disorders are a significant concern in individuals with Down syndrome.
- The bimodal onset and varying seizure types necessitate tailored diagnostic and therapeutic approaches based on age and specific seizure presentation.
Abstract:
The prevalence, onset, and type of seizure disorders, as well as seizure control, were studied in a large cohort of 405 individuals with Down syndrome (age range, 6 months to 45 years). The evaluation of a questionnaire completed by the subjects' parents and of the patients' medical records indicated that 33 (8.1%) of 405 persons with Down syndrome had seizure disorder. With regard to the onset of seizures, a bimodal distribution was noted: 40% of patients began having seizures before the age of 1 year, and another 40% started with seizure activity in the third decade of life. In the younger age group, primarily infantile spasms and tonic-clonic seizures with myoclonus were observed, and the older patients often had partial simplex or partial complex seizures as well as tonic-clonic seizures.