[The etiology of epilepsies in children by considering the case histories in comparison with a control group (author's transl)].

To clarify the etiology of epileptic illnesses in children a detailed questionnaire was prepared, with questions on both genetic factors and the possibility of pre-, peri- and postnatal injury. The questionnaire was filled out by the parents of 422 epileptic children and those of 150 healthy control children of the same age. The differences were statistically calculated by means of the x2 test, small values being corrected according to Yates. Hereditary factors were found in 10.2% of all patients, ranging from 5.6% to 13.5% for the various seizure types (control group:0.6%). A high rate of hereditary afflictions was found even in those types of seizure which are considered predominantly symptomatic (salaam [West] or myoclonic-astatic convulsions: 13.5%, focal attacks: 11.2%). The significance of some exogenic factors, e.g. illnesses during pregnancy, prematurity, birth complications, was statistically confirmed in some instances for all types, in other instances only for certain types of seizure. As regards other factors, however, whose causative role has hitherto been considered proven or at least very probable, no differences were found between patients and controls (e.g. protracted labor, uterine inertia, coiling of the umbilical cord). Confirmation was found for the generally accepted rule that exogenic injuries are most often demonstrable in children with salaam or myoclonic-astatic convulsions and least often in those with absences. In conclusion, it is emphasized that an absolute dividing line can no longer be drawn between genetic and symptomatic epilepsies; in many cases the exogenic influence merely serves as a touching-off factor for a gentic epilepsy.