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Prevalence, classification, and severity of epilepsy and epileptic syndromes in children
1Medical School, University of Tampere and Department of Pediatrics, Tampere University Hospital, Finland.
Insights
This study found a childhood epilepsy prevalence of 3.94 per 1,000 children in Finland. While most cases were classifiable, 17% were intractable, highlighting the need for better epilepsy syndrome classification.
Area of Science:
- Neurology
- Pediatrics
- Epidemiology
Background:
- Childhood epilepsy is a significant neurological concern with varying prevalence globally.
- Accurate classification of epileptic seizures and syndromes is crucial for prognosis and treatment.
Purpose of the Study:
- To determine the point prevalence of active childhood epilepsy in a defined Finnish population.
- To evaluate the utility of the International League Against Epilepsy (ILAE) classification for seizures and syndromes in children.
- To identify the proportion of severe epilepsy cases.
Main Methods:
- Retrospective review of medical records, neurophysiological recordings, and clinical data for children aged 0-15 years in a defined Finnish area.
- Application of the 1981 ILAE International Classification of Epileptic Seizures (ICES) and 1989 ILAE Classification of Epilepsies and Epileptic Syndromes (ICE).
- Calculation of age- and sex-specific prevalence rates and classification of seizure/epilepsy types and severity.
Main Results:
- The point prevalence of active childhood epilepsy was 3.94 per 1,000 children.
- 96% of seizures and 90% of epilepsies/syndromes were classifiable using ICES/ICE.
- Generalized seizures were more common in younger children (0-6 years), while partial/localization-related seizures predominated in older children (6-15 years).
- Intractable epilepsy occurred in 17% of cases, significantly associated with symptomatic etiology, early onset, and neuroimpairments.
Conclusions:
- The current ILAE classification has limitations, with many cases falling into nonspecific categories, impacting prognostic value.
- A relatively low proportion of intractable cases suggests a good prognosis for many childhood epilepsies, particularly when neuroimpairments are absent.
Purpose:
To determine the point prevalence of active childhood epilepsy in a defined area and evaluate the usefulness of ILAE classification of seizures, and epilepsies/syndromes with special interest in severe epilepsies.
Methods:
By using the latest ILAE International Classification of Epileptic Seizures (ICES, 1981) and Epilepsies and Epileptic Syndromes (ICE, 1989), we determined the age- and sex-specific prevalence rates of epilepsy, type of seizures, epilepsies, and recognizable epileptic syndromes, as well as the proportion of severe cases in each seizure/epilepsy/syndrome category in all children 0-15 years of age from a geographically defined area in Finland. All medical records, neurophysiological recordings and available clinical data were reviewed retrospectively.
Results:
Point prevalence of active epilepsy on December 12, 1992 was 3.94 per 1,000. According to ICES/ICE, we were able to classify 96% of seizures and 90% of epilepsies and syndromes. Generalized seizure and epilepsy/syndrome types were more prevalent in children 0-6 years of age and partial/localization-related in children 6-15 years of age. Epilepsy was intractable in 17% of all cases and correlated significantly with symptomatic etiology and early onset of epilepsy, as well as with additional neuroimpairments.
Conclusions:
A considerable number of cases fell into the nonspecific categories of ICE, which limits the value of present epilepsy/syndrome classification in terms of prognosis, prediction, and indication for special investigations in individual cases. A number of intractable cases was relatively low, indicating good prognosis in many childhood epilepsies, especially when additional neuroimpairments are absent.