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Acute symptomatic seizure disorders in young children--a population study in southern Taiwan
C C Huang1, Y C Chang, S T Wang
1Department of Pediatrics, National Cheng Kung University Medical Center, Tainan, Taiwan.
Insights
Acute symptomatic seizures in children are common, with gastroenteritis and infections being leading causes. Many seizures are preventable, and some children may develop unprovoked seizures later.
Area of Science:
- Pediatrics
- Neurology
- Epidemiology
Background:
- Acute symptomatic seizures are a significant concern in pediatric neurology.
- Understanding their incidence, causes, and long-term outcomes is crucial for effective management.
Purpose of the Study:
- To determine the incidence, etiology, and prognosis of acute symptomatic seizures in children up to 3 years of age.
- To identify risk factors for subsequent unprovoked seizures.
Main Methods:
- A population-based birth cohort study involving 15,209 neonatal survivors.
- Telephone surveys and medical record reviews were used to collect data on seizures in 13,493 children at age 3.
Main Results:
- The incidence of acute symptomatic seizures was 0.46 per 100 children.
- Leading causes included acute gastroenteritis, encephalitis/encephalopathy, and bacterial meningitis, varying by age group.
- 14% of children with acute symptomatic seizures developed subsequent unprovoked seizures by age 5.
Conclusions:
- Many acute symptomatic seizures are preventable through public education and vaccination.
- Underlying causes significantly influence the risk of future unprovoked seizures.
- Preventive strategies should focus on addressing shaken-baby syndrome, water intoxication, and widespread vaccination against bacterial meningitis.
Purpose:
To determine the incidence, etiology, and prognosis of acute symptomatic seizures in children by age 3 years.
Methods:
In a population-based birth cohort study of all 15,209 neonatal survivors born in Tainan City between October 1989 and December 1991, parents or caretakers of 13,493 children aged 3 years were surveyed by telephone regarding any provoked convulsive disorder, particularly acute symptomatic seizure, in the children; medical records were reviewed.
Results:
Sixty-three children (39 boys, 24 girls) had acute symptomatic seizures (incidence 0.46 in 100). The leading causes of acute symptomatic seizures were acute gastroenteritis, encephalitis/encephalopathy, and bacterial meningitis. Age-specific incidence was highest in the group aged 1-12 months. Intracranial hemorrhage, bacterial meningitis, and metabolic disturbance were the major causes of acute symptomatic seizures in children aged 1-12 months. Acute gastroenteritis, encephalitis/encephalopathy, and bacterial meningitis accounted for 85% of the causes in children aged 13-24 months, and gastroenteritis and encephalitis/encephalopathy were the predominant causes in those aged 25-36 months. By age 5 years, subsequent unprovoked seizures developed in 14% of the survivors of acute symptomatic seizures.
Conclusions:
Many acute symptomatic seizures are preventable. The risk of subsequent unprovoked seizures is determined by underlying precipitating factors. Public education regarding the danger of shaken-baby syndrome and excessive water supplement, as well as and nationwide vaccination against bacterial meningitis in young children, is necessary.