Epilepsy in the first 10 years of life: findings of the child health and education study.

OBJECTIVES

To identify children with afebrile seizures in a national cohort, classify the seizures, and document progress in the first 10 years of life.

DESIGN

Population based birth cohort study.

SETTING

The child health and education study, which includes 16,004 neonatal survivors (98.5% of infants born in the United Kingdom during one week of April 1970).

SUBJECTS

14,676 children for whom relevant information was available.

MAIN OUTCOME MEASURES

Responses to parental and general practitioner questionnaires and hospital records at 5 and 10 years after birth.

RESULTS

84 children (42 boys, 42 girls) had had one or more afebrile seizure (incidence 5.7/1000). 63 children (31 boys, 32 girls) had epilepsy (incidence 4.3/1000). 49 of 55 children had a second seizure within a year of the first. The commonest seizure types were tonic-clonic (42) and complex partial (25). A greater proportion of children with complex partial seizures had recurrences. Children who had infantile spasms or a mixed seizure disorder had a poor outcome. All six children who died had symptomatic seizures in the first year, but seizures were not the direct cause of death.

CONCLUSIONS

The results of this study are probably representative of seizure patterns in the general population. Outcome after seizures is determined more by the underlying disease than by the seizures themselves.