Incidence Of Epilepsy In Children Research Articles

Epidemiology of self-limited epilepsy with centrotemporal spikes (SeLECTS): A population study using primary care records

Background and objectiveInformation on self-limited epilepsy with centrotemporal spikes (SeLECTS) epidemiology is limited. We aimed to determine the incidence of SeLECTS in children, its association with socioeconomic deprivation and the prevalence of neurodevelopmental comorbidities. MethodWe performed a retrospective cohort study (2004–2017) using anonymised, linked, routinely collected, primary care and demographic data for children in Wales. We used primary care diagnosis codes to identify children (aged 0–16 years) with SeLECTS and other epilepsies and to record antiseizure medication (ASM) prescriptions and neurodevelopmental comorbidities. We used a mixed effects Poisson regression model to determine temporal trends of SeLECTS incidence and its association with socioeconomic deprivation. ResultsWe identified 6,732 children with epilepsy, 186 (3%) with SeLECTS. In 2017, epilepsy and SeLECTS prevalence was 0.55% and 0.02% respectively with corresponding crude incidence of 51.2/100,000/year and 1.1/100,000/year. The incidence of epilepsy in children decreased with decreasing deprivation with an adjusted incidence rate ratio (AIRR) of 0.72 (95% CI 0.64–0.82) in the least deprived compared with the most deprived quintile. The corresponding AIRR for children with SeLECTS was 1.35 (95% CI 0.46–1.99). 34% of children with epilepsy, 18% of children with SeLECTS and 3% of all children in Wales had a neurodevelopmental disorder and or school problems. Half of children with SeLECTS were treated with ASM. ConclusionsWe identified a lower than previously reported incidence of SeLECTS, which may be due to under-recording of SeLECTS. There was no change in the incidence of SeLECTS over time, whilst the incidence of childhood epilepsy overall was decreasing. There was no significant association between incidence of SeLECTS and deprivation but the modest sample size needs to be considered. Children with SeLECTS should be screened for neurodevelopmental and or learning comorbidities. Treatment for SeLECTS remains debatable.

Prevalence, incidence, and trends of epilepsy among children and adolescents in Africa: a systematic review and meta-analysis

BackgroundEpilepsy contributes to a significant disease burden in children and adolescents worldwide. The incidence of childhood epilepsy is threefold higher in low and middle income countries compared in high-income countries. Epilepsy is a serious neurological condition associated with stigma and discrimination, an impaired quality of life, and other mental health related problems.ObjectiveThis study is aimed to synthesize existing evidence and estimate the pooled prevalence and incidence of epilepsy in children and adolescents in Africa.MethodsA comprehensive and systematic search of relevant databases was conducted. The quality of each study was assessed using the Newcastle-Ottawa Quality Assessment Scale adapted for meta-analysis. Two reviewers screened retrieved articles, conducted critical appraisals, and extracted the data. Heterogeneity between studies was assessed by visual inspection of forest plots and statistically using Cochran’s Q statistics and the I2 test. Publication bias was checked by visual inspection of funnel plots as well as statistically using Egger’s correlation and Begg’s regression tests. Finally, the pooled prevalence and incidence of childhood epilepsy were computed with 95% confidence intervals.ResultIn this review and meta-analysis 42 studies with 56 findings were included to compute the pooled prevalence of childhood epilepsy. On the other hand, 6 studies were included to estimate the combined incidence. The pooled prevalence of cumulative epilepsy was 17.3 per 1000 children. Whereas the pooled prevalence of active and lifetime epilepsy was 6.8 and 18.6 per 1000 children respectively. The pooled incidence of childhood epilepsy was 2.5 per 1000 children.ConclusionNearly 1 in 50 children are suffering from epilepsy in Africa. However, little attention has been paid to the prevention and treatment of childhood epilepsy. Mass epilepsy screening, scaling up treatment coverage, and designing strict treatment follow up and monitoring mechanisms are recommended.

STUDY OF THE PROBLEM OF CHILDREN’S EPILEPSY IN THE REPUBLIC OF SAKHA (YAKUTIA)

Epilepsy is one of the most common diseases of the nervous system in children. According to WHO, more than 50 million people worldwide suffer from epilepsy. It is estimated that the proportion of the general population with its active form (that is, with recurrent seizures and the need for treatment) currently ranges from 4 to 10 per 1,000 people. Globally, 2.4 million people are diagnosed with this disease every year. In Russia, epilepsy affects more than 1 million people. The analysis of statistical data on the prevalence and incidence of epilepsy in children in the Republic of Sakha (Yakutia) was carried out. In Yakutia, the first epidemiological study of epilepsy in the pediatric population was conducted in 1985 by E.A. Krivogornitsyna. As a result of the survey, data were obtained on 322 children who were registered at the dispensary with neurologists and psychiatrists in 32 districts of the republic and the city of Yakutsk. According to the study of the epidemiology of epilepsy in children in 2004 (Baisheva G.M., 2004), the prevalence of epilepsy was 5.2 per 1,000 children of the Republic of Sakha (Yakutia), and the primary incidence was 114 per 100,000 children. Prevalence of epilepsy in children under 14 years of age in 2020 was 5.4 per 1,000 population, the primary incidence was 50 per 100,000 population. On average, from 2010 to 2020, the primary incidence of epilepsy in children is 80 per 100,000 population. The prevalence of epilepsy in adolescents aged 15 – 17 years averaged 10.4 %. The average value of primary morbidity in this group of children was 140 per 100,000 population. The organization of comprehensive medical care will make it possible to form a strategy for the management of epilepsy patients at the municipal and republic levels.

Epilepsy and frequent nocturnal enuresis among children in Shanghai, China

<h2>Summary</h2><h3>Introduction</h3> Nocturnal enuresis (NE) is a common elimination problem that affects physical and psychological health of children older than 5 years, and more than 80% of them are primary. Frequent nocturnal enuresis (FNE) usually refers to involuntary urination more than 4 times a week during sleep. Children who frequently wet the bed are more likely to become adults with NE. The arousal dysfunction in response to micturition desire is the main pathogenesis of NE. Epilepsy is a common neurological disorder, which essentially reflects various diseases of brain dysfunction. Previous studies had suggested a possible association between epilepsy and NE. <h3>Objectives</h3> To examine the association between epilepsy and FNE and to investigate the related risk factors of FNE. <h3>Study design</h3> This was an in-depth analysis of a population-based cross-sectional study in Shanghai, China. There were 74 252 children aged 3–12 years old recruited using the multi-stage stratified cluster random sampling method. After ruling out 11 962 (16.1%) children aged less than 5 years, a total of 62 290 children were included in the study. They were surveyed for the demographic characteristics via questionnaires. In this study, IBM SPSS Statistics Version 23 was used for data analysis. Chi-square, t-test, univariable and multivariable logistic regression models were used. <h3>Results</h3> The epilepsy rate was significantly higher in children with FNE (2.1%) than that in children without (0.3%). After adjusting for confounding factors (sex, gestational age, birth weight, maternal age, academic performance, parent' education level, annual household income and autism spectrum disorder) in multivariable models, the incidence of epilepsy in children with FNE was 6.254 times higher than that in children without. Moreover, the adjusted OR was higher in girls than that in boys. Regarding age, the association between epilepsy and FNE existed exclusively among children aged 9–12 years. <h3>Discussion</h3> In the study, epilepsy was significantly associated with FNE, girls and preadolescent children were at higher risk. Puberty begins earlier in girls than in boys. Increased secretion of hormones might affect susceptibility to both epilepsy and FNE. It is hypothesized that persistent brain injury caused by multiple seizures may lead to progression to FNE in patients with NE. However, this was a preliminary investigation. The potential to diagnosis previously unrecognized epilepsy among children with FNE was not addressed by this study. <h3>Conclusion</h3> There was a significantly increased risk of epilepsy in children with FNE, especially in girls and preadolescent children.Summary TableMultivariable logistic regression models to analyse the association of Epilepsy with FNE, and the association of Epilepsy with FNE in different genders and age groups.Summary TableAdjusted OR∗95% CIP ValueEpilepsy6.2542.612–14.973＜0.001Age5–6 years old6.9150.882–54.2100.0667–8 years old0.0000.0000.9989–12 years old9.8773.609–27.027＜0.001GenderGirl9.9002.839–34.521＜0.001boy4.9171.438–16.8110.011OR: odds ratios, CI: confidence intervals.∗The confounding factors included autism spectrum disorder, gestational age, birth weight, maternal age, academic performance, parents' education level, annual household income and sex.

Hubungan Riwayat Kejang Demam dengan Kejadian Epilepsi pada Anak di Rumah Sakit Santa Elisabeth Lubuk Baja Kota Batam

Background: Epilepsy is a disease that can reduce the quality of human life characterized by epileptic seizures. Many epilepsy cases in Indonesia are still undetected, many people with epilepsy do not visit health centers because they do not know about the disease. The exact cause of epilepsy is not known. Children who have a history of febrile seizures can cause epilepsy. Methods:The method of this research is descriptive analytic with cross sectional approach which is conducted at Santa Elisabeth Lubuk Baja Hospital, Batam City. The sample in this research uses the formula of Slovin and obtained a total sample of 98 people. Data were collected using medical records. The data obtained werw analyzed using the Chi-Square test. Results:The results of the analysis of pediatric epilepsy based on abnormal EEG patients had a history of febrile seizures as many as 25 children (37.9%) while those without a history of febrile seizures were 41 children (62.1%). Children with epilepsy based on clinical had a history of febrile seizures as many as 5 children (15.6%) while those without a history of febrile seizures were 27 children (84.4%). The results obtained p value of 0.045, meaning that there is a significant relationship between a history of febrile seizures and the incidence of epilepsy. Conclusion:There is a correlation between a history of febrile seizures and the incidence of epilepsy in children at the Santa Elisabeth Lubuk Baja Hospital, Batam City in 2021.

Порівняння поширеності, захворюваності та інвалідності з нервових хвороб і епілепсії серед дитячого населення Харківської області й України

У статті надані результати зіставлення поширеності, захворюваності та інвалідності з нервових хвороб і епілепсії серед дитячого населення Харківської області й України і порівняння отриманих результатів із світовими показниками. В 2015 році серед дитячого населення 0–17 років в Україні зареєстровано 407 618 дітей із хворобами нервової системи, що становить 53,53 випадку на 1000 дитячого населення, середній показник за 5 років — 459 300 дітей (58,354 ‰), в Харківській області — 36 494 дитини (86,28 ‰), середній показник — 39 883 дитини (94,476 ‰). Поширеність епілепсії в Україні становить 25 695 випадків (3,21 ‰) та перевищує поширеність дитячого церебрального паралічу, нейроінфекції, середній показник за 5 років — 24 667 випадків (3,144 ‰), в Харківській області — 1451 випадок (3,43 ‰), середній показник — 1340 випадків (3,21 ‰). Захворюваність дітей на хвороби нервової системи в Україні становить 140 494 випадки (18,45 ‰), середній показник за 5 років — 159 215 дітей (20,29 ‰), в Харківській області — 11 871 дитина (28,07 ‰), середній показник — 13 795 дітей (33,068 ‰). Захворюваність на епілепсію в Україні в дітей становить 3306 випадків (0,43 ‰), середній показник за 5 років — 3569 дітей (0,454 ‰), в Харківській області — 252 дитини (0,53 ‰), середній показник — 201,2 дитини (0,468 ‰). В Україні за останні 5 років відзначається тенденція до зниження поширеності та захворюваності на хвороби нервової системи в дітей, а в Харківській області в 2014–2015 рр. спостерігається збільшення цих показників, що пов’язано, мабуть, з міграцією населення. У структурі інвалідності дітей віком до 18 років в Україні хвороби нервової системи займають 2-ге місце та становлять 29 684 випадки (37,1 на 10 000 дітей), питома вага — 17,6 %, в Харківській області — 1770 (41,8 на 10 000 дітей). Таким чином, надані результати роботи дозволили проаналізувати групу дітей до 18 років c захворюваннями нервової системи, визначити ряд епідеміологічних показників по Харківській області, оцінити в першу чергу місце і значення епілепсії, порівняти отримані дані з загальноукраїнськими. Це в подальшому дозволить провести порівняльні характеристики і більш поглиблені дослідження проблеми по всій Україні для оптимізації надання медичної допомоги дітям.

COMPARISON BETWEEN CARBAMAZEPINE AND VALPROATE ON LIPID PROFILE AND LIPOPROTEIN (a)

Introduction: Aseizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in behaviour, movements or feelings, and in level of consciousness The high incidence of epilepsy in children coupled with the need of long term antiepileptic treatment could lead to development of metabolic complications at an early age and hence the risk of atherosclerosis. The changes in serum lipid and lipoprotein (a) levels do play an important role in atherosclerosis and cardiovascular complications in later life. Aim: In view of the above facts the present study aims to evaluate the change in the level of lipids and lipoprotein (a) during the course of treatment of epilepsy with different antiepileptic drugs. Materials and Methods:Aprospective follow up study was conducted on 19 children (10 on carbamazepine and 9 on valproate) in Department of Paediatrics at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana. The duration of study was one and a half year. A detailed history was taken with complete clinical examination. Biochemical parameters like lipid prole, Lipoprotein(a), liver enzymes along with relevant investigations were done before starting anti- epileptic monotherapy and were followed up after 6 month of treatment.Results: Out of 19 children with seizure 10 on carbamazepine showed signicant increase (p &lt; 0.05) in the levels of lipoprotein (a), TG (triglyceride), TC (total cholesterol), LDL(low density lipids), VLDL(very low density lipids) after six months of treatment and 9 children on Valproate didn't show signicant increase in lipid prole and lipoprotein (a) whereas has signicant change in levels of SGPT (p &lt;0.05) after six month of monotherapy. Conclusion: Several antiepileptic drug like carbamazepine with CYP450 enzyme inducers activity may cause signicant rise in levels of lipids and lipoprotein (a), hence causing a potent risk factor for atherorsclerosis and cardiovascular complications in long term antiepileptic therapy; thus lipid prole and lipoprotein (a) should be monitored during the course of treatment

Demographic and Clinical Characteristics of Epilepsy in Childhood: A Prospective Cross Sectional Study from Sudan

Background: Epilepsy is a common neurological disorder affecting around 1% of children. The incidence in Sudan is likely to be higher given the high rate of genetic disorders related to consanguity and acquired disorders caused by CNS infection and birth injury. Epilepsy can be idiopathic or non-idiopathic, symptomatic epilepsy indicates a known cause while cryptogenic epilepsy implies a presumed unknown cause. Objective: To understand the demographic and clinical characteristics of epilepsy in children in the setting of a tertiary epilepsy clinic in Khartoum, Sudan. Methods: This is a hospital-based cross sectional study recruiting patients with epilepsy attending a tertiary pediatric neurology clinic. All patients attending the clinic in the 6 month period were included. Data was collected by medical students and was analyzed on IBM SPSS Version 20.0 in a descriptive fashion. Results: 284 Children were recruited. The mean age for children with epilepsy was 5.74 (range 0-12 Years). Females constituted 59.9%; while 94.7% of patients were of low socioeconomic status. The most common type of seizures found were generalized tonic clinic at 51.8% (147/284), followed by focal seizures at 21.1% (60/284). 71% of our patients (201/284) had no identifiable cause (idiopathic), while 29% were non-idiopathic. Of the non-idiopathic group; 41% were due to congenital anomalies, followed by HIE at 24.1%, infections at 16.9% trauma at 10.8% and tumors at 7.2%. Only 18.3% (52/284) had a positive family history of epilepsy. Conclusions: There appears to be a higher incidence of epilepsy in Children with low socio – economic status with a slight female predominance. The incidence of idiopathic epilepsy appears to be similar to inter-national figures. We recommend broader community based and long-term studies for better understanding of epilepsy in Sudan.

An association between the rs1799853 and rs1057910 polymorphisms of CYP2C9, the rs4244285 polymorphism of CYP2C19 and the prevalence rates of drug-resistant epilepsy in children

Objective Epilepsy is a neurologically based disease. Literature data indicate a certain association between the polymorphism of these genes, which participate in the metabolism of drugs (CYP), and drug-resistant epilepsy. Aim The reports describe studies in which an association was evaluated between the rs1799853 (430C > T) and rs1057910 (1075A > C) polymorphisms of CYP2C9 gene and the rs4244285 (c.681G > A) polymorphism of CYP2C19 gene on one hand and the incidence of drug-resistant epilepsy in children on the other. Material and methods The above-mentioned polymorphisms were assessed by the PCR-RFLP technique in a group of patients with drug-resistant (n = 106) and drug-responsive (n = 80) epilepsy, as well as in non-epileptic children (n = 97), all of them hospitalised at the Department of Neurology of the Institute-Polish Mother’s Memorial Hospital in Lodz. Results It was demonstrated that CT genotype of the rs1799853 polymorphism of CYP2C9 gene and GA genotype of the rs4244285 polymorphism of CYP2C19 gene caused an enhanced risk of epilepsy. It was also shown that the occurrence of C-G-A haplotype, when referred to the rs1799853 polymorphism of CYP2C9 gene and the rs4244285 polymorphism of CYP2C19 gene, could be associated with a decreased risk of epilepsy occurrence. In case of the rs1799853 polymorphism in CYP2C9 gene, the occurrence of T allele four times increases the risk of drug-resistance in patients with diagnosed epilepsy. Conclusion The obtained results indicated that the rs1799853 and rs1057910 polymorphisms of CYP2C9 gene and the rs4244285 polymorphism of CYP2C19 gene could be associated with the occurrence of drug-resistant epilepsy in children.

Early epilepsy in children with Zika-related microcephaly in a cohort in Recife, Brazil: Characteristics, electroencephalographic findings, and treatment response.

ObjectiveTo estimate the incidence of epilepsy in children with Zika‐related microcephaly in the first 24 months of life; to characterize the associated clinical and electrographic findings; and to summarize the treatment responses.MethodsWe followed a cohort of children, born during the 2015‐2016 Zika virus (ZIKV) epidemic in Brazil, with congenital microcephaly and evidence of congenital ZIKV infection on neuroimaging and/or laboratory testing. Neurological assessments were performed at ≤3, 6, 12, 15, 18, 21, and 24 months of life. Serial electroencephalograms were performed over the first 24 months.ResultsWe evaluated 91 children, of whom 48 were female. In this study sample, the cumulative incidence of epilepsy was 71.4% in the first 24 months, and the main type of seizure was infantile spasms (83.1%). The highest incidence of seizures occurred between 3 and 9 months of age, and the risk remained high until 15 months of age. The incidence of infantile spasms peaked between 4 and 7 months and was followed by an increased incidence of focal epilepsy cases after 12 months of age. Neuroimaging results were available for all children, and 100% were abnormal. Cortical abnormalities were identified in 78.4% of the 74 children evaluated by computed tomography and 100% of the 53 children evaluated by magnetic resonance imaging. Overall, only 46.1% of the 65 children with epilepsy responded to treatment. The most commonly used medication was sodium valproate with or without benzodiazepines, levetiracetam, phenobarbital, and vigabatrin.SignificanceZika‐related microcephaly was associated with high risk of early epilepsy. Seizures typically began after the third month of life, usually as infantile spasms, with atypical electroencephalographic abnormalities. The seizure control rate was low. The onset of seizures in the second year was less frequent and, when it occurred, presented as focal epilepsy.

The effect of single nucleotide polymorphisms of STAT3 on epilepsy in children.

To investigate the effect of single nucleotide polymorphisms (SNPs) of signal transducer and activator of transcription 3 (STAT3) on epilepsy in children. A total of 169 children suffering from epilepsy admitted in No. 1 People's Hospital of Jining from July 2015 to December 2016 were enrolled as the research subjects. Immunohistochemistry and real time-PCR were used for analysis of the expression of STAT3 and p-STAT3 in epilepsy patients. The genotypes and alleles of rs1053005 and re744166 were analyzed through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Statistical analysis was conducted to explore the correlation between the polymorphism of STAT3 and the incidence of epilepsy in children, and the polymorphism of STAT3 in the drug-resistant and non-resistant patients was compared. Both the STAT3 and p-STAT3 were over-expressed in epilepsy patients. The GG genotype of rs1053005 was significantly lower in epilepsy patients than that of health control, p<0.05. By contrast, no significant difference was found in genotypes of rs744166 between epilepsy and healthy children. When comparing the genotypes of drug-resistant patients and that of non-resistant patients, the distribution of rs1053005 genotypes in the two groups showed a significant difference, p<0.05. No statistical difference was observed in rs744166 genotypes. STAT3 polymorphism was associated with the risk of epilepsy and drug resistance to epilepsy. This study may provide a better understanding of STAT3 in epilepsy patients and provide new targets for the treatment of epilepsy patients.

Incidence of early-onset epilepsy: A prospective population-based study

PurposeThe first five years of life reflect a critical period of development prior to formal education yet few epidemiological studies focus on children with early-onset epilepsy (CWEOE; onset <60 months). This study aimed to determine early-onset epilepsy incidence using a comprehensive case identification strategy, and examined socioeconomic status (SES) and ethnicity as risk factors. MethodsThrough a prospective, population-based study, newly diagnosed CWEOE from Fife and Lothian, Scotland, were identified using multiple-source, active surveillance capture-recapture between May 2013 and June 2015. Crude, ascertainment-adjusted, age-adjusted, age- and gender-specific, and epilepsy-type incidence rates were determined. Risk ratios (RR) were calculated to examine SES and ethnicity as risk factors. Results59 (36 Male) CWEOE were identified. Ascertainment was 98% (95% CI 94–103). Crude annual incidence of epilepsy in children 0–59 months was 60.2 (95% CI 44.8–75.5) per 100,000 per year; ascertainment-adjusted annual incidence was 61.7 (95% CI 46.2–77.3) per year. Cumulative incidence of West Syndrome/Infantile Spasms was 6.7 per 10,000 live births (95% CI 3.6–12.3). Aetiology was unknown in almost two-thirds of CWEOE. Compared to White-British Isles (BI) children, Asian children (RR 2.6 [95% CI 1.2–5.7], p = .02) and White-non-BI children (RR 2.5 [95% CI 1.2–5.2], p = .02) had increased risk. SES was not a risk factor. ConclusionThe high incidence of early-onset epilepsy is similar to previous studies and demonstrates a substantial disease burden. Cause of epilepsy remains unknown in almost two thirds of CWEOE. Ethnicity but not SES affects early-onset epilepsy risk.

Incidence of epilepsy in children born prematurely and small for gestational age at term gestation: A population-based cohort study.

This study assessed the incidence of epilepsy in preterm infants and those small for gestational age (SGA) at term and identified risk factors associated with higher epilepsy incidence in these children. We enrolled children (from 2000 to 2010) who were premature (n = 21 474) or SGA (n = 2206); we then included a matched control cohort (n = 94 720). Cox regression was used to assess the epilepsy risk in preterm and SGA children. To determine the associated factors for epilepsy, the preterm and SGA infants were divided into six groups according to the common complications related to brain development and were separated into three subgroups based on birthweight (BW). The cumulative incidence of epilepsy was significantly higher in preterm or SGA children than in the control group. The overall incidence densities (per 1000 person-years) of epilepsy were: 0.37 in the control, 2.96 in the preterm, 2.90 in the SGA, 15.9 in the preterm with cerebral haemorrhage, 14.6 in the SGA with cerebral haemorrhage, 6.92 in the preterm with asphyxia, 3.82 in the SGA with asphyxia, 14.3 in the preterm with congenital brain anomalies, and 25.4 in the SGA with congenital brain anomalies cohorts. Infants with BW < 1000 g had a higher incidence of epilepsy than those with BW ≥2500 g. Preterm and SGA infants had an increased risk of epilepsy in childhood, and the incidence of epilepsy increased with decreasing BW. Several perinatal factors (e.g. intracranial haemorrhage, birth asphyxia and congenital brain anomalies) are associated with a higher incidence of later epilepsy.

Dynamics of Epidemiological Indications of Epilepsy Prevalence, Morbidity and Disability among Children in Kharkiv Region, Ukraine

Objective Introduction: According to the World Health Organization, epilepsy is one of the most common diseases of the central nervous system, which affects 0.5 to 2% of the entire population The aim is comparison of prevalence, incidence and disability from nervous diseases and epilepsy among children of the Kharkiv region of Ukraine and the results are compared with global figures. Patients and methods Materials and methods: Epidemiological indicators, namely the prevalence and incidence. For the comparative analysis, the statistical data of the last 5 years are used. Results Review: The prevalence of epilepsy in Ukraine amounts to 25 695 children (3.21%), higher than the prevalence of cerebral palsy or neuroinfections, the average value for 5 years is 24 667 children (3.144%). In the Kharkiv region the number is 1 451 children (3.43%), 5-year average is 1 340 children (3.21%). The incidence of epilepsy in children in Ukraine is 3 306 children (0.43%), the average value for 5 years is 3 569 children (0.454%). In Kharkiv region the incidence is 252 persons (0.53%), an average is 201.2 children (0.468%). Conclusion Conclusions: Reliable epidemiological indicators will make it possible to improve the system of rendering specialized medical care to children with epilepsy, carry out a pharmaco-economic analysis, calculation and estimation of the costs for patients' treatment, which is especially important in the framework of the health care system reformation. Thus, the compilation of patients' registers with epilepsy is one of the urgent tasks to optimize the medical care.

Incidence of Epilepsy after Neonatal Seizures: A Population-Based Study

Background: The incidence of childhood and adolescence epilepsy varies in different areas and over time. Published reports in the Italian pediatric population are few and there is no information on the incidence of epilepsy using the new clinical definition of the disease signed by the International League Against Epilepsy. An increased risk of epilepsy is reported in subjects who presented with neonatal seizures (NS), but few population-based studies are available that compare incidence and age at onset of epilepsy in children with and without NS. Objectives: Ascertain the incidence of epilepsy in children in the province of Parma by applying the new practical clinical definition of epilepsy, and compare incidence and age of epilepsy onset in children with and without previous NS. Methods: The study was carried out in the province of Parma, Emilia-Romagna Region, Northern Italy, using different data sources (clinical records and administrative data), and considered all the children born in the province of Parma between January 2002 and December 2014 and developing epilepsy by December 2016. We calculated the incidence of epilepsy in patients up to 14 years of age, incidence of epilepsy after NS and cumulative incidence of epilepsy at 1, 5, and 10 years’ follow-up. To evaluate age at onset of epilepsy, we divided patients into 3 groups (epilepsy onset within 1 month, between 1 and 12 months, and after 1 year of life) and we compared age at onset of epilepsy between patients who had had previous NS and those who had not. Results: The incidence of epilepsy was 78.6/100,000 persons-years (boys 88.1/100,000, girls 68.6/100,000). The incidence of epilepsy after NS was 15.2% (8.2% for male, 23.5% for female; 16.3% in born at term, 14.3% in pre-term). The incidence of epilepsy at 1, 5, and 10 years’ follow-up was higher in patients with previous NS than in others. The age at onset of epilepsy was significantly different in the 2 groups, and was younger in those with history of NS: mean age at onset was 10.5 months in those with NS and of 61.8 months in the others. Conclusions: The incidence rate of epilepsy in the Parma district was higher than that reported in other Italian areas studied, probably due to the different methodology used and the application of the most recent definition of epilepsy. Children with NS were at higher risk of epilepsy and develop the disease at a younger age.

Epilepsia em idade pediátrica – casuística da consulta de pediatria de um hospital distrital

Introduction and Objectives: Epilepsy represents one of the most frequent neurologic diseases in children and adolescents, with a prevalence of four to six cases per 1000 children. The aim of the present study is to analyze clinical and epidemiological characteristics of patients with epilepsy followed in a pediatric outpatient department of a level II hospital.Methods: Retrospective review of the clinical files of patients followed in a pediatric-neurologic diseases consultation between May 2009 and June 2014. The epileptic seizures were classified according to the International League Against Epilepsy.Results: The study included 42 patients, 54.8% males, with a median age at diagnosis of 78 months (IQR 5-205). Four children (9.5%) had a history of prematurity, three (7.1%) needed resuscitation maneuvers after birth, one (2.4%) had a previous neurologic impairment and three (7.1%) had a history of febrile seizures. Family history of epilepsy was positive in 53.7% of cases. Seizure types were generalized in 60% of the children, predominantly tonic-clonic. After the first seizure, 98% of children performed electroencephalography, that was abnormal in 69% of the cases and in these patients treatment was initiated with anti-epileptic drugs. The brain imaging was performed in 27 patients (64.3%) and was abnormal in four (15.4%). Of the 42 patients, half had new seizures. Because they had recurrent seizures, it was necessary to add a new anti-epileptic drug in seven children (16.7%). Morbidities were detected in 30% of children, especially cognitive impairment (21.4%).Conclusion: The clinical history and the electroencephalography are essential for the diagnosis of epilepsy. The prognosis is good in most children. Longitudinal studies should be planned in order to determine the national incidence of epilepsy in children and its characteristics.

Assessment of serum lipid profile and liver function parameters in children with epilepsy on phenytoin or valproic acid monotherapy for 6 months and beyond

Objectives: The highest incidence of epilepsy in children coupled with the need of long-term antiepileptic treatment could lead to development of metabolic complications at an early age. Phenytoin and valproic acid are commonly used antiepileptic drugs in children. This study aimed to assess the serum lipid profile and liver function tests in children with epilepsy on phenytoin or valproic acid monotherapy for 6 months and beyond. Materials and Methods: This prospective descriptive study recruited children from the pediatric outpatient department of a tertiary care GB Pant Children Hospital, Srinagar, Kashmir, India from August 2009 to September 2011. All consecutive children diagnosed with epilepsy as per International League Against Epilepsy definition aged 3–18 years on phenytoin or valproic acid monotherapy for 6 months or beyond were enrolled. After baseline clinical and anthropometric evaluation (including body mass index [BMI]), the fasting blood samples were analyzed for serum lipid profile and liver enzyme changes. Results: Total of 75 children were enrolled. There were 25 patients each in phenytoin, valproic acid, and control group. We observed statistically significant high mean total cholesterol and alkaline phosphatase levels in group receiving phenytoin when compared with valproic acid or control group. Conclusion: The lipid and liver enzyme abnormalities may be observed in children on phenytoin or valproic acid therapy, which warrants careful screening and monitoring.

The epidemiology of epilepsy in children in the Republic of Belarus

To study the incidence of epilepsy in children in the Republic of Belarus based on the data of the Republican Centre for disease control. Statistical analysis of the incidence and morbidity of epilepsy in children and adolescents was performed. Based on this analysis, the contribution of epilepsy in the neurologic morbidity in childhood was analyzed. The morbidity and incidence of epilepsy in children averaged 0.35 and 2.4 per 1000 of the child population, respectively, over the last 6 years (2009-2014). The peak incidence of primary epilepsy is between the ages 1-4 years (0.43 per 1000 population for 12 years (2003-2014), of incidence of epilepsy among children, aged 0-17 years, are stable with no significant fluctuations for the last 6 years (2009-2014). The proportion of epilepsy in the structure of neurological disorders (9.51%) remained unchanged. In the period 2003-2014, general incidence of epilepsy among children, aged 5-9 years, has increased from 2.2 to 2.6 per 1000 child population (p<0.05) and from 2.5 to 3.8 (p<0.05) in children, aged 15-18 years, with no changes in the morbidity.

EPILEPSY IN CHILDREN WITH STROKE

The frequency of detection of stroke in children has increased over the last 25 years (from 1.3 to 13/100 000). The children identified more than 100 risk factors for stroke, but more than a third of cases the cause is not identified. We have analyzed the incidence of epilepsy in children with stroke and risk factors to evaluate the possibility of occurrence of epileptic seizures. It handled 280 case histories of children who had a stroke in the period from 2013 to August 2015 (excluding children with perinatal stroke and bleeding with severe brain injuries) treated at the Morozov Children'sClinicalHospital. All children held in the dynamics of EEG, psychological testing, repeat MRI. The diagnosis of epilepsy had 24 children (8.6%) of the treated patient records. Ischemic stroke was diagnosed in 62%, hemorrhagic – 38%. In HS, prevailed children aged up to 3 years, with ischemic from 6 to 14 years. The most common attacks made their debut from 12 to 24 months after a stroke, some earlier occurrence of attacks observed in hemorrhagic stroke, from 1 month to 12 months (77%). Only 3/24 (12.5%) children seizures were observed in the acute phase stroke. In 71% was a combination of several types of attacks. Two of the children diagnosed with idiopathic forms epilepsy – childhood absence and juvenile myoclonic. Evaluation of the outcome of stroke scale PSOM-SNE and pathopsychological evaluation by the Achenbach revealed more severe neuropsychological problems in children with stroke with epileptic seizures than those without epilepsy.

Abstract 18284: Incidence of Epilepsy is Elevated in Children and Young Adults With Congenital Heart Defects Compared With the General Population: A Nationwide Cohort Study

Perioperative seizures related to surgery for congenital heart defects (CHD) are well described; however, few data exist on the long-term risk of epilepsy in patients with CHD. We aimed to estimate the incidence of epilepsy in children and young adults with CHD compared with the general population. Methods: Utilizing data from the Danish National Registry of Patients (DNRP) we identified all patients diagnosed with CHD before the age of 15 years between 1980 and 2010 who were born during the same period. The DNRP is a nationwide hospital discharge registry covering all Danish hospitals. Previously validated methodology using the DNRP was applied to measure the outcome, epilepsy, as well as presence of extra cardiac defects (ECD) and/or syndromes. We used the Danish Medical Birth Registry to identify preterm birth (gestational age&lt;37 weeks). For each CHD subject, we identified 10 controls from the general population using the Danish Civil Registration System, matched by sex and birth year. A unique personal identifier assigned at birth and used in all Danish public registries enabled virtually complete follow up for migration, death, or epilepsy until January 1, 2013. We computed cumulative incidences and hazard ratios (HR) (split at 5 years of age to obtain proportional hazards) of time from CHD diagnosis (index date for controls) to epilepsy. Results: We identified 14,665 CHD subjects with a median age at diagnosis of 2 (IQR 19) months. By 15 years of age, the cumulative incidence of epilepsy was 4% among CHD subjects. The HR of epilepsy among CHD subjects compared with the control cohort was 3.7 (95% CI: 3.2-4.3) below 5 years of age, and 2.4 (95% CI: 2.1-2.7) from 5 to 33 years of age. In the older age group, HR for patients with severe CHD was 2.8 (95% CI: 2.3-3.5), and for mild and moderate CHD was 2.2 (95% CI: 1.8-2.6). After exclusion of all subjects with ECDs and/or syndromes and preterm birth, corresponding HRs were 2.2 (95% CI: 1.6-3.0) and 1.7 (95% CI: 1.3-2.2), respectively. Conclusion: The epilepsy risk was markedly increased in CHD subjects compared with the age and gender matched controls. These findings add evidence to support the importance of developing neuro-protective measures and potentially long-term epilepsy surveillance strategies in the CHD population.