Aaberg Kari Modalsli, Bakken Inger Johanne, Lossius Morten I, Lund Søraas Camilla, Håberg Siri Eldevik, Stoltenberg Camilla, Surén Pål, Chin Richard
Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway; National Center for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway;
Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway;
Pediatrics. 2016 Sep;138(3). doi: 10.1542/peds.2016-0921. Epub 2016 Aug 1.
Children with epilepsy are at increased risk of other disorders and difficulties, preceding, cooccurring with, or after the diagnosis of epilepsy. Risk estimates vary, few studies are population-based, and few provide comprehensive assessments of comorbidities. We used nationwide registry data to describe frequencies of medical, neurologic, developmental, and psychiatric conditions occurring before and after children are diagnosed with childhood epilepsy.
Data were obtained from the Norwegian Patient Registry, which is an administrative database recording International Classification of Diseases, 10th Revision diagnoses from all government-funded specialist health services in Norway (outpatient consultations and hospitalizations). We included data from the years 2008 through 2013 for all children born in Norway between 1996 and 2013 (0-17 years of age at the end of follow-up). Children with epilepsy were compared with the general child population, adjusting for sex and age. We also compared children with complicated epilepsies (ie, epilepsies with additional neurologic and/or developmental disorders) to children with uncomplicated epilepsies.
The study population included 1 125 161 children. There were 6635 (0.6%) children with epilepsy. Nearly 80% of children with epilepsy had ≥1 comorbid disorder. All types of disorders were more frequent in children with epilepsy, with additional medical disorders recorded in 55%, neurologic disorders in 41%, and developmental/psychiatric disorders in 43%. Children with complicated epilepsies had the highest overall levels of comorbidity, but the risk of medical and psychiatric comorbidities was also substantial among children with uncomplicated epilepsies.
The overall frequency of comorbid disease is high in children with epilepsy, including children with presumably uncomplicated epilepsies.
癫痫患儿出现其他疾病和困难的风险增加,这些疾病和困难可在癫痫诊断之前、同时或之后出现。风险评估结果各异,基于人群的研究较少,且很少有研究对合并症进行全面评估。我们利用全国登记数据来描述儿童被诊断为儿童癫痫之前和之后发生的医疗、神经、发育和精神疾病的频率。
数据来自挪威患者登记处,这是一个行政数据库,记录了挪威所有政府资助的专科医疗服务(门诊会诊和住院治疗)的国际疾病分类第十版诊断信息。我们纳入了1996年至2013年在挪威出生的所有儿童(随访结束时年龄为0至17岁)2008年至2013年的数据。将癫痫患儿与普通儿童群体进行比较,并对性别和年龄进行了调整。我们还将患有复杂性癫痫(即伴有其他神经和/或发育障碍的癫痫)的儿童与患有非复杂性癫痫的儿童进行了比较。
研究人群包括1125161名儿童。有6635名(0.6%)癫痫患儿。近80%的癫痫患儿患有≥1种合并症。癫痫患儿中所有类型的疾病都更为常见,另外有55%记录有医疗合并症,41%有神经合并症,43%有发育/精神合并症。患有复杂性癫痫的儿童合并症总体水平最高,但在患有非复杂性癫痫的儿童中,医疗和精神合并症的风险也很高。
癫痫患儿,包括可能患有非复杂性癫痫的患儿,合并疾病的总体发生率较高。