Åndell Eva, Tomson Torbjörn, Carlsson Sofia, Hellebro Eva, Andersson Tomas, Adelöw Cecilia, Åmark Per
Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, 611 85 Nykoping, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden.
Epilepsy Res. 2015 Jul;113:140-50. doi: 10.1016/j.eplepsyres.2015.04.002. Epub 2015 Apr 16.
To evaluate the incidence of unprovoked seizures in children and the prevalence of related neurodevelopmental comorbidities at the time of the presumed first seizure and six months thereafter.
The medical records of all children (0-18 years of age) seeking medical attention as the result of a first unprovoked seizure between September 1, 2001 and December 31, 2006, and registered in the population-based Stockholm Incidence Registry of Epilepsy (SIRE) were reviewed. Neurodevelopmental comorbidities were evaluated on the basis of the medical records from this first visit and from other healthcare during the following six months.
The incidence of unprovoked seizures was between 30 and 204/100,000 person years (n=766) in the different age groups. It was highest among the youngest children and lowest among the 18-year-olds with small gender differences. The most common neurodevelopment comorbidities were developmental delay (22%, CI: 19-25%), speech/language and learning difficulties (23%, CI: 20-26%) and intellectual disability (16%, CI: 13-18%). The types of neurodevelopmental comorbidity varied by age at the time of seizure onset, with cerebral palsy being more common among the 0-5-year-olds, attention deficits among the 6-16-year-olds, and autism and psychiatric diagnosis among the older children. An associated neurodevelopmental comorbidity was more common among those experiencing recurrent than single seizures during follow-up six months from the index seizure (42% versus 66%). In 68% (CI: 64-71%) of the children there was no known or suspected neurodevelopmental comorbidity.
The incidence of unprovoked, non-febrile seizures among 0-18-year-olds included in the SIRE was 67/100,000 person-years. Neurodevelopmental comorbidities were common already at the time of onset of the seizure disorder, indicating that neither seizure treatment nor seizures were the underlying cause of other neurodevelopmental symptoms in these patients during the period studied.
评估儿童无诱因癫痫发作的发生率以及首次疑似癫痫发作时及此后六个月相关神经发育合并症的患病率。
回顾了2001年9月1日至2006年12月31日期间因首次无诱因癫痫发作而就医并登记在基于人群的斯德哥尔摩癫痫发病率登记处（SIRE）的所有儿童（0至18岁）的病历。根据首次就诊时的病历以及接下来六个月内的其他医疗记录评估神经发育合并症。
不同年龄组无诱因癫痫发作的发生率为每100,000人年30至204例（n = 766）。在最小的儿童中发生率最高，在18岁儿童中最低，性别差异较小。最常见的神经发育合并症是发育迟缓（22%，可信区间：19 - 25%）、言语/语言和学习困难（23%，可信区间：20 - 26%）以及智力残疾（16%，可信区间：13 - 18%）。神经发育合并症的类型因癫痫发作开始时的年龄而异，脑瘫在0至5岁儿童中更常见，注意力缺陷在6至16岁儿童中更常见，自闭症和精神疾病诊断在年龄较大的儿童中更常见。在首次癫痫发作后的六个月随访期间，与复发性癫痫发作相比，单次癫痫发作的患者中相关神经发育合并症更常见（42%对66%）。68%（可信区间：64 - 71%）的儿童没有已知或疑似的神经发育合并症。
纳入SIRE的0至18岁儿童中无诱因、非热性癫痫发作的发生率为每100,000人年67例。在癫痫发作疾病发作时神经发育合并症就很常见，这表明在所研究的时期内，癫痫治疗和癫痫发作均不是这些患者其他神经发育症状的根本原因。
