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Clinical Factors and Comorbidities Associated With Uncontrolled Seizures in Children With Epilepsy: A Nationwide
Panisra Sudachan1, Sirorat Suwannachote2, Puangtong Bunyatumma3
1Department of Pediatric Neurology, Neurological Institute of Thailand, Bangkok, Thailand.
Insights
Comorbid diseases, including cerebral palsy and developmental issues, are linked to uncontrolled seizures in children with epilepsy. This national survey highlights key factors impacting seizure control in pediatric epilepsy patients.
Area of Science:
- Pediatric Neurology
- Epilepsy Research
- Public Health
Background:
- Childhood epilepsy significantly impacts children and families, with higher comorbidity rates than the general pediatric population.
- Limited evidence exists on the association between comorbid diseases and seizure control in pediatric epilepsy.
- This study investigated the link between comorbid conditions and seizure control in children with epilepsy using national data.
Purpose of the Study:
- To determine if comorbid diseases in children with epilepsy are associated with poor seizure control.
- To identify specific comorbid conditions that correlate with uncontrolled seizures in pediatric epilepsy patients.
- To analyze factors influencing seizure control in a nationwide cohort of children with epilepsy.
Main Methods:
- A national survey was conducted involving children under 18 years old treated at 12 Thai hospitals.
- Clinical data, including comorbid diseases, were collected for all participants.
- Logistic regression analysis was used to identify factors associated with uncontrolled seizures.
Main Results:
- The study included 4,558 children with epilepsy; 27.71% had uncontrolled seizures.
- Five factors predicted uncontrolled seizures: age at onset, epilepsy duration, seizure type, comorbid diseases, and imaging lesions.
- Comorbid diseases increased the odds of uncontrolled seizures by 1.80 (95% CI: 1.43–2.28).
- Neurological conditions like cerebral palsy (OR 2.16) and motor deficits (OR 1.99) were significant.
- Developmental issues, including autism (OR 1.56) and intellectual disability (OR 1.49), were also associated with uncontrolled seizures.
Conclusions:
- Age at onset, epilepsy duration, seizure type, comorbid diseases, and imaging lesions are significant factors for uncontrolled seizures in children nationwide.
- Six neurodevelopmental comorbid diseases were identified as significant contributors to uncontrolled seizures in this pediatric epilepsy cohort.
Background:
Childhood epilepsy is a common disease and has large impact on children and their families. Children with epilepsy are more likely to have comorbid diseases compared to general child population. However, there is limited evidence if comorbid diseases in children with epilepsy are associated with seizure control. This study aimed to evaluate if any comorbid diseases in children with epilepsy associated with seizure control by a national database.
Methods:
This study was a national survey of children with an age of less than 18 years of age who were currently treated at 12 hospitals in Thailand. Clinical factors including comorbid diseases were recorded. Factors associated with seizure uncontrolled were executed by using logistic regression analysis.
Results:
There were 4,558 children with epilepsy enrolled in the national survey. Of those, 1,263 children (27.71%) were defined as uncontrolled seizure. There were five significant factors in the predictive model for seizure uncontrolled: age at onset of epilepsy, duration of epilepsy, seizure type, comorbid diseases, and imaging lesions. The presence of comorbid disease had adjusted odds ratio of 1.80 (95% confidence interval of 1.43, 2.28). Among 11 neurological comorbid diseases, cerebral palsy and motor deficit had significant adjusted odds ratio of 2.16 and 1.99. Four developmental comorbid diseases had significant adjusted odds ratio: developmental problems, learning ability, autism, and intellectual disability/mental retardation. These four factors had adjusted odds ratios of 2.05, 1.27, 1.56, and 1.49, respectively.
Conclusions:
Five significant clinical factors associated with seizure uncontrolled in children with epilepsy nationwide including age at onset of epilepsy, duration of epilepsy, seizure type, comorbid diseases, and imaging lesions. Six neurodevelopmental comorbid diseases were also significant factors associated with seizure uncontrolled in this setting.
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