Incidence of early-onset epilepsy: A prospective population-based study. (February 2020)

• Record Type: Journal Article
• Authors: Hunter, Matthew B.; Yoong, Michael; Sumpter, Ruth E.; Verity, Kirsten; Shetty, Jay; McLellan, Ailsa; Chin, Richard F.M.
• Is Part Of: Seizure. Volume 75(2020)
• Page Start: 49
• Page End: 54
• Publication Date: 2020-02
• Subjects: Epidemiology -- Socioeconomic status -- Ethnicity -- West syndrome -- Infants -- Children; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2019.12.020
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Incidence of epilepsy (0–59 months) is 61.7 (95%CI 46–77)/100, 000 children per year. Incidence of early-onset epilepsy is similar to previous studies over recent decades. One third with early-onset epilepsy have a known genetic or structural aetiology. West Syndrome/Infantile Spasms incidence is 6.7 (95%CI 1.2–5.7) /10, 000 live births. Ethnicity was an early-onset epilepsy risk factor but socioeconomic status was not. Abstract: Purpose: The 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. Methods: Through 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. Results: 59 (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. Conclusion: The 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.