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Prevalence of the epilepsies in children and adolescents
L D Cowan1, J B Bodensteiner, A Leviton
1University of Oklahoma Health Sciences Center, Department of Biostatistics and Epidemiology, Oklahoma City 73190.
Insights
The study found a childhood epilepsy prevalence of 4.71 per 1,000 in central Oklahoma. Epilepsy was most common in toddlers, with higher rates in males and Black children, often idiopathic and with comorbidities.
Area of Science:
- Pediatric Neurology
- Epidemiology
- Public Health
Background:
- Epilepsy affects a significant number of children and adolescents.
- Understanding the prevalence and characteristics of childhood epilepsy is crucial for public health planning and resource allocation.
- Previous studies may not fully capture the epidemiology in specific geographic regions.
Purpose of the Study:
- To determine the prevalence of epilepsy in children and adolescents (birth to 19 years) in two central Oklahoma counties.
- To analyze demographic variations (age, sex, race) in epilepsy prevalence.
- To identify common epilepsy types, presumed causes, and comorbidities in this pediatric population.
Main Methods:
- Case ascertainment through multiple sources: hospitals, clinics, physicians' offices, EEG labs, and emergency rooms.
- Calculation of prevalence rates per 1,000 population for the defined age group and geographic area.
- Analysis of demographic data, epilepsy types, etiologies, and co-occurring medical conditions.
Main Results:
- A total of 1,159 cases yielded a prevalence rate of 4.71 per 1,000 children and adolescents.
- Prevalence peaked in the 1-4 year age group. Males showed a slightly higher overall prevalence (M:F = 1.1), with variations by age and epilepsy type.
- Epilepsy was more prevalent in Black children compared to white children, particularly in generalized epilepsies. Common types included tonic-clonic seizures. Approximately 70% were idiopathic, with perinatal factors, trauma, and CNS infections as noted causes. Motor handicap and developmental delay were frequent comorbidities.
Conclusions:
- Childhood epilepsy in central Oklahoma affects approximately 4.71 per 1,000 individuals under 19.
- Demographic factors like age, sex, and race significantly influence epilepsy prevalence and type.
- A substantial proportion of pediatric epilepsy cases are idiopathic and associated with other medical conditions, highlighting the need for comprehensive care.
Abstract:
The prevalence of epilepsy in children and adolescents from birth through age 19 years was determined for residents of two counties in central Oklahoma. Cases, identified from hospitals, clinics, private physicians' offices, and EEG laboratory and emergency room records, numbered 1,159, yielding a prevalence rate of 4.71 per 1,000. The prevalence was highest in children aged 1-4 years. Overall, males had a slightly higher prevalence rate than females (M:F = 1.1). However, the male/female ratio varied by age, with the group aged less than 1 year having the highest ratio (M:F = 1.5), and by type of epilepsy, with males having higher rates of simple partial epilepsy (M:F = 1.8) and infantile spasms (M:F = 1.5). The prevalence of epilepsy was higher in blacks than in whites. Differences in prevalence by race were confined primarily to generalized epilepsies (B:W = 1.8). The most common types of epilepsy were tonic, clonic, and tonic-clonic (1.14 per 1,000), complex partial (0.39 per 1,000), and partial seizures secondarily generalized (0.33 per 1,000). Approximately 70% of cases were considered idiopathic. Among the presumed causes were perinatal factors (7%), trauma (4%), central nervous system (CNS) infection (3%), and congenital/developmental factors (3). Sixty-five percent of cases had at least one additional medical problem. The most common types of comorbidity were motor handicap (13%) and developmental delay (24%).