Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden; Research Department, Young Epilepsy, Surrey, UK; Institute of Child Health, University College London, London, UK.
Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden; Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden.
Pediatr Neurol. 2017 Sep;74:80-86.e2. doi: 10.1016/j.pediatrneurol.2017.05.027. Epub 2017 Jun 8.
There is a recently well-documented association between childhood epilepsy and earlysymptomaticsyndromeselicitingneurodevelopmentalclinicalexaminations (ESSENCE) including autism spectrum disorder, but the relationship between febrile seizures and ESSENCE is less clear.
The Child and Adolescent Twin Study in Sweden (CATSS) is an ongoing population-based study targeting twins born in Sweden since July 1, 1992. Parents of 27,092 twins were interviewed using a validated DSM-IV-based interview for ESSENCE, in connection with the twins' ninth or twelfth birthday. Diagnoses of febrile seizures (n = 492) and epilepsy (n = 282) were based on data from the Swedish National Patient Register. Prevalence of ESSENCE in individuals with febrile seizures and epilepsy was compared with prevalence in the twin population without seizures. The association between febrile seizures and ESSENCE was considered before and after adjustment for epilepsy. Age of diagnosis of febrile seizures and epilepsy was considered as a possible correlate of ESSENCE in febrile seizures and epilepsy.
The rate of ESSENCE in febrile seizures and epilepsy was significantly higher than in the total population without seizures (all P < 0.001). After adjusting for epilepsy, a significant association between febrile seizures and autism spectrum disorder, developmental coordination disorder, and intellectual disability remained. Earlier age of onset was associated with all ESSENCE except attention-deficit/hyperactivity disorder in epilepsy but not with ESSENCE in febrile seizures.
In a nationally representative sample of twins, there was an increased rate of ESSENCE in childhood epilepsy and in febrile seizures. Febrile seizures alone could occur as a marker for a broader ESSENCE phenotype.
儿童癫痫与早期症状性神经发育临床检查（ESSENCE），包括自闭症谱系障碍之间存在着最近有充分文献记录的关联，但热性惊厥与 ESSENCE 之间的关系尚不明确。
瑞典儿童和青少年双胞胎研究（CATSS）是一项正在进行的基于人群的研究，针对自 1992 年 7 月 1 日以来在瑞典出生的双胞胎。在双胞胎九岁或十二岁生日时，通过基于 DSM-IV 的验证访谈，对 27092 对双胞胎的父母进行了 ESSENCE 的访谈。热性惊厥（n=492）和癫痫（n=282）的诊断基于瑞典国家患者登记处的数据。与无惊厥的双胞胎人群相比，比较了热性惊厥和癫痫患者中 ESSENCE 的患病率。在调整癫痫后，考虑了热性惊厥与 ESSENCE 之间的关联。热性惊厥和癫痫的诊断年龄被认为是热性惊厥和癫痫中 ESSENCE 的可能相关因素。
热性惊厥和癫痫患者中 ESSENCE 的发生率明显高于无惊厥的总人群（均 P<0.001）。在调整癫痫后，热性惊厥与自闭症谱系障碍、发育协调障碍和智力障碍之间仍存在显著关联。发病年龄较早与除注意力缺陷/多动障碍以外的所有 ESSENCE 均相关，但与热性惊厥的 ESSENCE 无关。
在具有代表性的双胞胎样本中，儿童癫痫和热性惊厥患者中 ESSENCE 的发生率增加。热性惊厥本身可能作为更广泛 ESSENCE 表型的标志物出现。
