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Prevalence and incidence of epilepsy in Tokyo
1Department of Human Genetics, Tokyo Metropolitan Institute for Neurosciences, Japan.
Insights
Epilepsy incidence in children is low, with a cumulative rate of 4.3/1,000. Children with a single nonfebrile seizure or febrile convulsions have a higher risk of developing epilepsy.
Area of Science:
- Neurology
- Pediatrics
- Epidemiology
Background:
- Epilepsy is a common neurological disorder in childhood.
- Understanding the incidence and risk factors for childhood epilepsy is crucial for early intervention and management.
Purpose of the Study:
- To determine the cumulative incidence of epilepsy and single nonfebrile seizures in a pediatric population.
- To investigate the association between febrile convulsions, single nonfebrile seizures, and the development of epilepsy.
- To assess the prevalence of active and inactive epilepsy in children.
Main Methods:
- A prospective cohort study of 17,044 children aged 3 years in Tokyo, followed for 6-11 years.
- Neurological examinations and seizure history collection.
- Analysis of epilepsy development in relation to prior single nonfebrile seizures, febrile convulsions, and EEG abnormalities.
Main Results:
- The cumulative incidence of epilepsy was 4.3/1,000, and single nonfebrile seizures was 4.7/1,000.
- Febrile convulsions were observed in 82/1,000 children.
- Children with febrile convulsions had a 17/1,000 incidence of epilepsy, and those with a single nonfebrile seizure had a 50% chance of recurrence.
- Epilepsy developed by age 14 in approximately 2% of children with febrile convulsions and 0.2% of healthy children.
Conclusions:
- Childhood epilepsy has a low cumulative incidence, but specific risk factors like febrile convulsions and single nonfebrile seizures increase the likelihood of developing epilepsy.
- Early identification of risk factors and prompt neurological assessment are important for managing childhood epilepsy.
Abstract:
All children 3 years of age on January 1, 1975 in the Fuchu area of Tokyo were neurologically examined for 6 years (number examined: 17,044). The cumulative incidence of epilepsy (i.e., recurrent nonfebrile seizures) was 4.3/1,000 and that of occurrence of a single nonfebrile seizure (NS) was 4.7/1,000. Febrile convulsions (FCs) were observed in 82/1,000 in this population. The population was followed for 6-11 years after the first examination. During the follow-up (a) 4 of 80 children who had a single NS before age 3 years developed recurrence after age 3 years; (b) development of epilepsy was found in three of 1,323 randomly (10%) selected healthy children for comparison (2.3/1,000); (c) among 1,406 children with FCs, epilepsy developed in 24 (17/1,000) and a single NS occurred in 28 (20/1,000); and (d) the total cumulative incidence of epilepsy was 8.2/1,000 in the population aged 9-14 years. Age-specific annual incidence of epilepsy was highest in the age range 0-1 year (1.9/1,000), gradually falling with advancing age. The point prevalence for active epilepsy (having had a seizure within the past 5 years) was 2.8/1,000; that for inactive epilepsy was 5.4/1,000 (total 8.2/1,000). Epilepsy developed by age 14 years in (a) one-half of children with NS, (b) approximately 2% children with FCs, (c) 0.2% of healthy children with no seizure before age 3 years, and (d) an estimated 2% of potential epileptic carriers (having spike EEG abnormality by age 3; 15% of the population) who had not had a seizure by age 3 years.