1
|
Biset G, Abebaw N, Gebeyehu NA, Estifanos N, Birrie E, Tegegne KD. Prevalence, incidence, and trends of epilepsy among children and adolescents in Africa: a systematic review and meta-analysis. BMC Public Health 2024; 24:771. [PMID: 38475724 PMCID: PMC10935902 DOI: 10.1186/s12889-024-18236-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Epilepsy contributes to a significant disease burden in children and adolescents worldwide. The incidence of childhood epilepsy is threefold higher in low and middle income countries compared in high-income countries. Epilepsy is a serious neurological condition associated with stigma and discrimination, an impaired quality of life, and other mental health related problems. OBJECTIVE This study is aimed to synthesize existing evidence and estimate the pooled prevalence and incidence of epilepsy in children and adolescents in Africa. METHODS A comprehensive and systematic search of relevant databases was conducted. The quality of each study was assessed using the Newcastle-Ottawa Quality Assessment Scale adapted for meta-analysis. Two reviewers screened retrieved articles, conducted critical appraisals, and extracted the data. Heterogeneity between studies was assessed by visual inspection of forest plots and statistically using Cochran's Q statistics and the I2 test. Publication bias was checked by visual inspection of funnel plots as well as statistically using Egger's correlation and Begg's regression tests. Finally, the pooled prevalence and incidence of childhood epilepsy were computed with 95% confidence intervals. RESULT In this review and meta-analysis 42 studies with 56 findings were included to compute the pooled prevalence of childhood epilepsy. On the other hand, 6 studies were included to estimate the combined incidence. The pooled prevalence of cumulative epilepsy was 17.3 per 1000 children. Whereas the pooled prevalence of active and lifetime epilepsy was 6.8 and 18.6 per 1000 children respectively. The pooled incidence of childhood epilepsy was 2.5 per 1000 children. CONCLUSION Nearly 1 in 50 children are suffering from epilepsy in Africa. However, little attention has been paid to the prevention and treatment of childhood epilepsy. Mass epilepsy screening, scaling up treatment coverage, and designing strict treatment follow up and monitoring mechanisms are recommended.
Collapse
Affiliation(s)
- Gebeyaw Biset
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, P.O.BOX: 1145, Ethiopia.
| | - Nigusie Abebaw
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Natnael Atnafu Gebeyehu
- School of Midwifery, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Natan Estifanos
- Department of Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Endalk Birrie
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, P.O.BOX: 1145, Ethiopia
| | - Kirubel Dagnaw Tegegne
- Department of Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
2
|
Honorato MM, Cremaschi RC, Coelho FMS. The challenges to control epilepsy in an isolated indigenous tribe in Brazil's Amazon: 15 years of follow-up. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:725-733. [PMID: 37402399 PMCID: PMC10468723 DOI: 10.1055/s-0043-1769125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/18/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Epilepsy is a common neurological disease that affects people all over the world, but it is rarely described in indigenous peoples. OBJECTIVE To study the epilepsy characteristics and risk factors for seizure control in people from an isolated indigenous population. METHODS This is a retrospective and historical cohort study conducted from 2003 to 2018 (15 years), at a neurology outpatient clinic, of 25 Waiwai tribes' indigenous individuals with epilepsy, inhabitants of an isolated forest reserve in the Amazon. Clinical aspects, background, comorbidities, exams, treatment, and response were studied. Factors that impacted seizure control over 24 months were identified using Kaplan-Meier curves and Cox and Weibull regression models. RESULTS The majority of cases started in childhood, with no difference regarding gender. Focal epilepsies were predominant. Most patients had tonic-clonic seizures. A quarter of them had a family history, and 20% had referred febrile seizures. There was intellectual disability in 20% of patients. Neurological examination and psychomotor development were altered in one third of the participants. The treatment controlled 72% of the patients (monotherapy in 64%). Phenobarbital was the most prescribed anti-seizure medication, followed by carbamazepine and valproate. The most relevant factors that impacted seizure control over time were abnormal neurological exam and family history. CONCLUSION Family history and abnormal neurological exam were predicted risk factors for refractory epilepsy. Even in an isolated indigenous tribe, the partnership between the indigenous people and the multidisciplinary team ensured treatment adherence. The public healthcare system must guarantee modern anti-seizure medications, mainly for this vulnerable population, which has no other source of treatment.
Collapse
Affiliation(s)
- Marcos Manoel Honorato
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
- Universidade do Estado do Pará, Centro de Ciências Biológicas e da Saúde, Departamento de Saúde Integrada, Santarém PR, Brazil.
| | - Renata Carvalho Cremaschi
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
| | - Fernando Morgadinho Santos Coelho
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Psicobiologia, São Paulo SP, Brazil.
| |
Collapse
|
3
|
Habtamu A, Argaw R, Tuli W, Moges A. Magnitude and Determinant Factors of Pediatrics Seizures in Pediatrics Emergency Unit at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2020: A Retrospective and Descriptive Study. Behav Neurol 2023; 2023:3967899. [PMID: 37485287 PMCID: PMC10361829 DOI: 10.1155/2023/3967899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/05/2023] [Accepted: 07/01/2023] [Indexed: 07/25/2023] Open
Abstract
Background One of the most prevalent medical problems affecting kids is epilepsy, which is the most prevalent chronic neurological condition in kids in both developed and developing nations. The spectrum of diseases that make up childhood epilepsy syndromes ranges from mild to potentially fatal. Children may experience seizures due to a variety of illnesses, such as infection, severe brain injury, and anatomical deformity. It is the foremost visit calculates in neurological and cognitive impedance in children in low-income countries as well as the foremost common reason for pediatric clinic confirmations in children from destitute countries. All things considered, constrained things have been conducted in Ethiopia. Hence, this ponder points to survey the size and related variables of pediatric seizures among children conceded to Tikur Anbessa pediatric emergency. Methods By looking through 256 patient charts, an institution-based retrospective cross-sectional analysis was done. Data collection utilized a systematic checklist that had been evaluated beforehand. The EpiData version 4.4.2.2 was used to enter the data, which was then exported for analysis to the SPSS version 25. Binary logistic regression and descriptive statistics were employed. Variables from the bivariate analysis that had a p-value of less than 0.25 were carried over to multivariate analysis. The strength and existence of the link were assessed using adjusted odds ratios with a 95% confidence interval and a p-value of 0.05, respectively. Result Patients' ages ranged from 3.7 to 2.8 years on average. 4.5% of patients had seizures, and 155 of them (60.5%) were men, with a male-to-female ratio of (1.5 : 1). Males and females experienced seizures on average at 1.3 (95% CI: 1.1, 1.5) and 2 (95% CI: 1.6, 2.5) years old, respectively. AOR: 2.68 (95% CI: 1.192, 6.68, p = 0.02) and AOR: 2.8 (95% CI: 2.576, 5.302, p = 0.04) both demonstrated statistically significant correlations with pediatric seizure. Conclusion A vast number of children experienced convulsions, with generalized seizures being the most prevalent form. The chances of a child having a seizure were linked to their family history and where they were born. Therefore, health workers and other people who are involved in healthcare need to work harder on the factors that they have already identified.
Collapse
Affiliation(s)
- Asaminew Habtamu
- Institute of Health Science, School of Nursing, Department of Emergency Medicine and Critical Care Nursing, Jimma University, Jimma, Ethiopia
| | - Rahel Argaw
- School of Medicine and Critical Care, College of Health Science and Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wagari Tuli
- School of Medicine and Critical Care, College of Health Science and Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ayalew Moges
- School of Medicine and Critical Care, College of Health Science and Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
4
|
Blue-Green (~480 nm) versus Blue (~460 nm) Light for Newborn Phototherapy-Safety Considerations. Int J Mol Sci 2022; 24:ijms24010461. [PMID: 36613904 PMCID: PMC9820095 DOI: 10.3390/ijms24010461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/15/2022] [Accepted: 12/03/2022] [Indexed: 12/29/2022] Open
Abstract
We have previously shown that the phototherapy of hyperbilirubinemic neonates using blue-green LED light with a peak wavelength of ~478 nm is 31% more efficient for removing unconjugated bilirubin from circulation than blue LED light with a peak wavelength of ~452 nm. Based on these results, we recommended that the phototherapy of hyperbilirubinemic newborns be practiced with light of ~480 nm. Aim: Identify and discuss the most prominent potential changes that have been observed in the health effects of phototherapy using either blue fluorescent- or blue LED light and speculate on the expected effects of changing to blue-green LED light phototherapy. Search the phototherapy literature using the terms neonate, hyperbilirubinemia, and phototherapy in the PubMed and Embase databases. Transitioning from blue fluorescent light to blue-green LED light will expose neonates to less light in the 400-450 nm spectral range, potentially leading to less photo-oxidation and geno-/cytotoxicity, reduced risk of cancer, and decreased mortality in extremely low-birthweight neonates. The riboflavin level may decline, and the increased production and retention of bronze pigments may occur in predisposed neonates due to enhanced lumirubin formation. The production of pre-inflammatory cytokines may rise. Hemodynamic responses and transepidermal water loss are less likely to occur. The risk of hyperthermia may decrease with the use of blue-green LED light and the risk of hypothermia may increase. Parent-neonate attachment and breastfeeding will be positively affected because of the shortened duration of phototherapy. The latter may also lead to a significant reduction in the cost of phototherapy procedures as well as the hospitalization process.
Collapse
|
5
|
Wilde VK. Neonatal Jaundice and Autism: Precautionary Principle Invocation Overdue. Cureus 2022; 14:e22512. [PMID: 35228983 PMCID: PMC8873319 DOI: 10.7759/cureus.22512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/05/2022] Open
|
6
|
Byrne S, Enright N, Delanty N. Precision therapy in the genetic epilepsies of childhood. Dev Med Child Neurol 2021; 63:1276-1282. [PMID: 34089185 DOI: 10.1111/dmcn.14929] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 12/18/2022]
Abstract
Despite recent advances in both the understanding and treatment of the epilepsies, the rate of refractory epilepsy has remained static for many years. However, given our greater understanding of the aetiology and genetic basis of many paediatric and adult epilepsies, there is now scope to expand treatment. In this review, we discuss the current and potential use of precision medicine in the genetic epilepsies of childhood. We will discuss how optimal control and a reduction in the rate of refractory seizures using targeted therapy could be developed and assessed. We propose a six-tier approach to defining precision therapeutics in epilepsy and discuss how this can be incorporated into a clinical trial design. The lower tiers (1-2) represent therapies in common usage that we know work for certain epilepsy syndromes but do not precisely target the underlying problem. They work to reduce seizures but do not directly or effectively attenuate the developmental phenotype. The higher tiers (5-6) are currently purely speculative and look to a future with highly disease-specific therapies based on correction of underlying genomic and proteomic issues. In order to achieve this, scientists will have to embark on a 'whole-omic' approach to understand the underlying pathophysiology in order to design a precision therapy. What this paper adds Epilepsy treatment is classified into six tiers depending on how precisely the mechanism of action addresses the aetiology. Tier 1 treatment is based on the historical response of certain epilepsy phenotypes to specific medication. Tier 6 concerns therapy targeting genes and networks that rescue the whole phenotype. Clinical trial infrastructure and population-based disease registries are necessary so that patients can participate in trials for novel precision therapies.
Collapse
Affiliation(s)
- Susan Byrne
- FutureNeuro SFI Research Centre and Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Paediatric Neurology, CHI at Crumlin, Dublin, Ireland
| | - Noelle Enright
- FutureNeuro SFI Research Centre and Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Paediatric Neurology, Great Ormond Street Hospital, London, UK
| | - Norman Delanty
- FutureNeuro SFI Research Centre and Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland
| |
Collapse
|
7
|
Wilde VK. Breastfeeding Insufficiencies: Common and Preventable Harm to Neonates. Cureus 2021; 13:e18478. [PMID: 34659917 PMCID: PMC8491802 DOI: 10.7759/cureus.18478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 11/05/2022] Open
Abstract
Insufficient milk intake in breastfed neonates is common, frequently missed, and causes preventable hospitalizations for jaundice/hyperbilirubinemia, hypernatremia/dehydration, and hypoglycemia - accounting for most U.S. neonatal readmissions. These and other consequences of neonatal starvation and deprivation may substantially contribute to fully preventable morbidity and mortality in previously healthy neonates worldwide. Previous advanced civilizations recognized this problem of breastfeeding insufficiencies and had an infrastructure to solve it: Wetnursing, shared nursing, and prelacteal feeding traditions used to be well-organized and widespread. Modern societies accidentally destroyed that infrastructure. Then, modern reformers missing a few generations of direct knowledge transmission about safe breastfeeding invented a new, historically anomalous conception of breastfeeding defined in terms of exclusivity. As that new intervention has become increasingly widespread, so too have researchers widely reported associated possible harms of the longer neonatal starvation/deprivation and later infant under-nutrition periods that it creates when breastfeeding is insufficient. Early insufficient nutrition/hydration has possible long-term effects including neurodevelopmental consequences such as attention deficit hyperactivity disorder, autism, cerebral palsy, cognitive and developmental delay, epilepsy, hearing impairment, kernicterus, language disorder, mood disorders, lower IQ, and specific learning disorder. Current early infant feeding guidelines conflict with the available evidence. Recent reform efforts have tended to focus on using more technology and measurement to harm fewer neonates instead of proposing the indicated paradigm shift in early infant feeding to prevent more harm. The scientific evidence is already sufficient to mandate application of the precautionary principle to feed neonates early, adequate, and often milk before mothers' milk comes in and whenever signs of hunger persist, mitigating possible risks including death or disability. In most contexts, the formula is the best supplementary milk for infants at risk from breastfeeding insufficiencies. National-level reviews of scientific evidence, health policy, and research methods and ethics are needed to initiate the early infant feeding paradigm shift that the data already support. Policy experiments and related legislative initiatives might also contribute to the shift, as insurers might decline or be required by law to decline reimbursing hospitals for costs of this type of preventable hospitalization, which otherwise generates profit.
Collapse
Affiliation(s)
- Vera K Wilde
- Methods, Ethics, and Technology, Independent Researcher, Berlin, DEU
| |
Collapse
|
8
|
Idris A, Alabdaljabar MS, Almiro A, Alsuraimi A, Dawalibi A, Abduljawad S, AlKhateeb M. Prevalence, incidence, and risk factors of epilepsy in arab countries: A systematic review. Seizure 2021; 92:40-50. [PMID: 34418747 DOI: 10.1016/j.seizure.2021.07.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/03/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the prevalence, incidence, and risk factors of epilepsy in Arab countries. METHODS In this systematic review, electronic databases including PubMed, ProQuest Public Health and Cochrane Library were searched to identify relevant English articles published until April 2020. The search was conducted to cover all 22 Arab countries. Studies were eligible for inclusion if they assessed any of these epidemiological parameters of epilepsy: prevalence, incidence, and/or risk factors and focused on at least one of the Arab countries. The quality of the studies was evaluated using standardized quality assessment tools. RESULTS Twenty-nine articles met the inclusion criteria. Out of the 22 Arab countries, only 11 were found to have published studies reporting on the epidemiology of epilepsy. The median lifetime prevalence of epilepsy in Arab countries was found to be 6.9 per 1000. The median incidence is 89.5 per 100000. The most frequently identified risk factors were parental consanguinity, family history of epilepsy, and a history of perinatal infections/insults. CONCLUSION The prevalence and incidence of epilepsy varies in Arab countries. The most frequently reported risk factor is parental consanguinity. The lack of epidemiological studies on epilepsy in half of the Arab countries calls for more studies on this aspect to identify the burden and risk factors of epilepsy in this region.
Collapse
Affiliation(s)
- Anas Idris
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Alyaman Almiro
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Anas Alsuraimi
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ahmad Dawalibi
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Mashael AlKhateeb
- Department of Neurosciences, King Faisal Specialty Hospital, and Research Center, Riyadh, Saudi Arabia.
| |
Collapse
|
9
|
Al Habbal A, AlSharif A, Almubark A, Fattouh H, Hamzeh G, Kakaje A. Risk factors associated with epilepsy in children and adolescents: A case-control study from Syria. Epilepsy Behav 2021; 114:107596. [PMID: 33246894 DOI: 10.1016/j.yebeh.2020.107596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/19/2020] [Accepted: 10/24/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Epilepsy is a major public health concern in low-income countries (LIC) as they contain 80% of total cases worldwide. Syria has been in war since 2011 which made it difficult to prevent epilepsy risk factors which made this the first study on that matter. METHODS This is a case-control study from 3 medical centers in Damascus, Syria. Data were collected using questionnaires introduced by trained doctors. The control group included patients from a general practice clinic while the cases were taken from the three pediatric neurology clinics. RESULTS The sample consisted of 334 patients with 167 cases and 167 controls. Multivariable analysis confirmed the association between positive family history (FH) in 1st degree (OR, 3.37, 95%CI 1.2-9.47) and 2nd degree relatives (OR, 3.98, 95%CI 1.84-8.62), febrile seizures whether they were simple (OR, 15.08, 95%CI 3.27-69.5) or complex (OR, 13.32, 95%CI 1.58-112.32), developmental delay/regression (OR, 14.31, 95%CI 6.3-32.49), and central nervous system (CNS) infection (OR, 34.05, 95%CI 2.02-573.92). Head trauma, parental factors, consanguinity, asphyxia parameters, and other risk factors were not found to be significantly associated with epilepsy (P > 0.05). CONCLUSION While some results were similar to other studies, others were not. Efforts should be made to facilitate healthcare access and proper diagnosis.
Collapse
Affiliation(s)
| | | | - Amjad Almubark
- Neurology Department, Children's University Hospital, Damascus, Syria
| | | | - Ghassan Hamzeh
- Neurology Department, Al Assad University Hospital, Damascus, Syria
| | | |
Collapse
|
10
|
Zavadenko NN, Nesterovskiy YE, Kholin AA, Vorobyeva IS. [Cognitive and paroxysmal disorders in the long-term period of traumatic brain injury in children and adolescents]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:110-117. [PMID: 30778041 DOI: 10.17116/jnevro2019119011110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Traumatic brain injury (TBI) clinical course and outcomes in children have peculiarities as the damage impacts brain, which growth and maturation are continuing. Thus, TBI interferes into normal processes of neuroontogenesis leading to negative consequences on the cognitive functions development, school education, social skills acquisition. Cognitive and behavioral disorders in children and adolescents in the long-term period of TBI become more prominent in co-occurrence with paroxysmal disorders, including posttraumatic headaches, posttraumatic epilepsy and subclinical epileptiform activity on the EEG. Therapeutic and rehabilitation procedures in in the long-term period of TBI in children and adolescents should be conducted not only during the first 12 months after injury, when they are expected to be the most efficient, but also later on taking into consideration continuing processes of the CNS morphological and functional maturation along with the high neuroplasticity of the developing brain.
Collapse
Affiliation(s)
- N N Zavadenko
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Yu E Nesterovskiy
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A A Kholin
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - I S Vorobyeva
- Pirogov Russian National Research Medical University, Moscow, Russia
| |
Collapse
|
11
|
Newman TB, Wu YW, Kuzniewicz MW, Grimes BA, McCulloch CE. Childhood Seizures After Phototherapy. Pediatrics 2018; 142:peds.2018-0648. [PMID: 30249623 DOI: 10.1542/peds.2018-0648] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2018] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5804915133001PEDS-VA_2018-0648Video Abstract BACKGROUND AND OBJECTIVES: In a recent Danish study, researchers found an increased risk of childhood epilepsy after phototherapy but only in boys. We investigated this association in a Kaiser Permanente Northern California cohort. METHODS From 499 642 infants born at ≥35 weeks' gestation in 1995-2011 followed for ≥60 days, we excluded 1773 that exceeded exchange transfusion thresholds and 1237 with seizure diagnoses at <60 days. We ascertained phototherapy, covariates, and outcomes from electronic records and existing databases. Our primary outcome was ≥1 encounter with a seizure diagnosis plus ≥1 prescription for an antiepileptic drug. We used Cox and Poisson models to adjust for bilirubin levels and other confounding variables. RESULTS A total of 37 683 (7.6%) infants received any phototherapy. The mean (SD) follow-up time was 8.1 (5.2) years. The crude incidence rate per 1000 person-years of the primary outcome was 1.24 among phototherapy-exposed children and 0.76 among those unexposed (rate ratio: 1.63; 95% confidence interval [CI]: 1.44 to 1.85). The adjusted hazard ratio (aHR) was 1.22 (95% CI: 1.05 to 1.42; P = .009). Boys were at higher risk of seizures overall (aHR = 1.18; 95% CI: 1.10 to 1.27) and had a higher aHR for phototherapy (1.33; 95% CI: 1.10 to 1.61) than girls (1.07; 95% CI: 0.84 to 1.37), although effect modification by sex was not statistically significant (P = .17). The adjusted 10-year excess risks per 1000 were 2.4 (95% CI: 0.6 to 4.1) overall, 3.7 (95% CI: 1.2 to 6.1) in boys, and 0.8 (95% CI: -1.7 to 3.2) in girls. CONCLUSIONS Phototherapy in newborns is associated with a small increased risk of childhood seizures, even after adjusting for bilirubin values, and the risk is more significant in boys.
Collapse
Affiliation(s)
- Thomas B Newman
- Departments of Epidemiology and Biostatistics, .,Pediatrics, and.,Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Yvonne W Wu
- Pediatrics, and.,Neurology, University of California, San Francisco, San Francisco, California; and
| | - Michael W Kuzniewicz
- Pediatrics, and.,Division of Research, Kaiser Permanente Northern California, Oakland, California
| | | | | |
Collapse
|
12
|
Thurman DJ, Begley CE, Carpio A, Helmers S, Hesdorffer DC, Mu J, Touré K, Parko KL, Newton CR. The primary prevention of epilepsy: A report of the Prevention Task Force of the International League Against Epilepsy. Epilepsia 2018; 59:905-914. [PMID: 29637551 PMCID: PMC7004820 DOI: 10.1111/epi.14068] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 02/05/2023]
Abstract
Among the causes of epilepsy are several that are currently preventable. In this review, we summarize the public health burden of epilepsy arising from such causes and suggest priorities for primary epilepsy prevention. We conducted a systematic review of published epidemiologic studies of epilepsy of 4 preventable etiologic categories-perinatal insults, traumatic brain injury (TBI), central nervous system (CNS) infection, and stroke. Applying consistent criteria, we assessed the quality of each study and extracted data on measures of risk from those with adequate quality ratings, summarizing findings across studies as medians and interquartile ranges. Among higher-quality population-based studies, the median prevalence of active epilepsy across all ages was 11.1 per 1000 population in lower- and middle-income countries (LMIC) and 7.0 per 1000 in high-income countries (HIC). Perinatal brain insults were the largest attributable fraction of preventable etiologies in children, with median estimated fractions of 17% in LMIC and 15% in HIC. Stroke was the most common preventable etiology among older adults with epilepsy, both in LMIC and in HIC, accounting for half or more of all new onset cases. TBI was the attributed cause in nearly 5% of epilepsy cases in HIC and LMIC. CNS infections were a more common attributed cause in LMIC, accounting for about 5% of all epilepsy cases. Among some rural LMIC communities, the median proportion of epilepsy cases attributable to endemic neurocysticercosis was 34%. A large proportion of the overall public health burden of epilepsy is attributable to preventable causes. The attributable fraction for perinatal causes, infections, TBI, and stroke in sum reaches nearly 25% in both LMIC and HIC. Public health interventions addressing maternal and child health care, immunizations, public sanitation, brain injury prevention, and stroke prevention have the potential to significantly reduce the burden of epilepsy.
Collapse
Affiliation(s)
- David J. Thurman
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Charles E. Begley
- Health Science Center at Houston School of Public Health, University of Texas, Houston, TX, USA
| | - Arturo Carpio
- Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador
| | - Sandra Helmers
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Dale C. Hesdorffer
- Gertrude H. Sergievsky Center and Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Jie Mu
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Kamadore Touré
- Department of Neurology, Fann University Hospital, Dakar, Senegal
| | - Karen L. Parko
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Charles R. Newton
- Kenya Medical Research Institute–Wellcome Trust Collaborative Program, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
| |
Collapse
|
13
|
Cruz-Cruz MDR, Gallardo-Elías J, Paredes-Solís S, Legorreta-Soberanis J, Flores-Moreno M, Andersson N. [Factors associated with epilepsy in children in Mexico: A case-control study]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2017; 74:334-340. [PMID: 29382476 DOI: 10.1016/j.bmhimx.2017.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/05/2017] [Accepted: 05/12/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Epilepsy is the most common chronic neurological disease in the world. In Mexico, epilepsy is among the diseases more related to mortality due to non-infectious diseases in children. The objective of the study was to identify the factors associated with epilepsy in children entitled to the Mexican Social Security Institute (IMSS), in Acapulco, Mexico. METHODS We carried out a case-control study from April 2010 to April 2011. We selected 118 cases from the database of outpatient pediatric neurology with epilepsy diagnostic with two year of evolution according to the International League Against Epilepsy criteria. We selected 118 controls from the same Medical Units where cases were detected. Data collected throughout an interview with the mothers included information on history of epilepsy among relatives, prenatal, perinatal and postnatal history. Bivariate and multivariate analysis was performed using Mantel-Haenszel process. RESULTS Multivariate analysis identified three factors associated with epilepsy: family history of epilepsy in first-degree relatives (adjusted Odds ratio (ORa) 2.44, 95%CI 1.18 -5.03), birth asphyxia (ORa 2.20, 95%CI 1.16-34.18), and urinary tract infection in the prenatal stage (ORa, 1.80, 95%CI 1.0 - 3.24). CONCLUSIONS Preventing birth asphyxia and urinary tract infections during pregnancy reduces the risk of epilepsy regardless of the history of epilepsy in first-degree relatives.
Collapse
Affiliation(s)
- Ma Del Rosario Cruz-Cruz
- Departamento Clínico de Pediatría, Hospital General Regional No. 1 "Vicente Guerrero", Acapulco, Guerrero, México
| | - Jorge Gallardo-Elías
- Departamento Clínico de Pediatría, Hospital General Regional No. 1 "Vicente Guerrero", Acapulco, Guerrero, México
| | - Sergio Paredes-Solís
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México.
| | - José Legorreta-Soberanis
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Miguel Flores-Moreno
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Neil Andersson
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México; Departamento de Medicina Familiar, Universidad de McGill, Montreal, Canadá
| |
Collapse
|
14
|
Razaz N, Tedroff K, Villamor E, Cnattingius S. Maternal Body Mass Index in Early Pregnancy and Risk of Epilepsy in Offspring. JAMA Neurol 2017; 74:668-676. [PMID: 28384785 DOI: 10.1001/jamaneurol.2016.6130] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance There is growing concern about the long-term neurologic effects of prenatal exposure to maternal overweight and obesity. The causes of epilepsy are poorly understood and, in more than 60% of the patients, no definitive cause can be determined. Objectives To investigate the association between early pregnancy body mass index (BMI) and the risk of childhood epilepsy and examine associations between obesity-related pregnancy and neonatal complications and risks of childhood epilepsy. Design, Setting, and Participants A population-based cohort study of 1 441 623 live single births at 22 or more completed gestational weeks in Sweden from January 1, 1997, to December 31, 2011, was conducted. The diagnosis of epilepsy as well as obesity-related pregnancy and neonatal complications were based on information from the Sweden Medical Birth Register and National Patient Register. Multivariate Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HRs) and 95% CIs after adjusting for maternal age, country of origin, educational level, cohabitation with partner, height, smoking, maternal epilepsy, and year of delivery. Data analysis was conducted from June 1 to December 15, 2016. Main Outcomes and Measures Risk of childhood epilepsy. Results Of the 1 421 551 children born between January 1, 1997, and December 31, 2011, with covariate information available, 7592 (0.5%) were diagnosed with epilepsy through December 31, 2012. Of these 3530 (46.5%) were female. The overall incidence of epilepsy in children aged 28 days to 16 years was 6.79 per 10 000 child-years. Compared with offspring of normal-weight mothers (BMI 18.5 to <25.0), adjusted HRs of epilepsy by maternal BMI categories were as follows: overweight (BMI 25.0 to <30.0), 1.11 (95% CI, 1.04-1.17); obesity grade I (BMI 30.0 to <35.0), 1.20 (95% CI, 1.10-1.31); obesity grade II (BMI 35.0 to <40.0), 1.30 (95% CI, 1.12-1.50); and obesity grade III (BMI≥40.0), 1.82 (95% CI, 1.46-2.26). The rates of epilepsy were considerably increased for children with malformations of the nervous system (adjusted HR, 46.4; 95% CI, 42.2-51.0), hypoxic ischemic encephalopathy (adjusted HR, 23.6; 95% CI, 20.6-27.1), and neonatal convulsions (adjusted HR, 33.5; 95% CI, 30.1-37.4). The rates of epilepsy were doubled among children with neonatal hypoglycemia (adjusted HR, 2.10; 95% CI, 1.90-2.33) and respiratory distress syndrome (adjusted HR, 2.43; 2.21-2.66), and neonatal jaundice was associated with more than a 50% increased risk of epilepsy (adjusted HR, 1.47; 95% CI, 1.33-1.63). The elevated risk of epilepsy in children of overweight or obese mothers was not explained by obesity-related pregnancy or neonatal complications. Conclusions and Relevance The rates of childhood epilepsy increased with maternal overweight or obesity in a dose-response manner. Given that overweight and obesity are modifiable, prevention of obesity may be an important public health strategy to reduce the incidence of childhood epilepsy.
Collapse
Affiliation(s)
- Neda Razaz
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Tedroff
- Neuropediatric Unit, Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Eduardo Villamor
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden3Department of Epidemiology, School of Public Health, and Center for Human Growth and Development, University of Michigan, Ann Arbor
| | - Sven Cnattingius
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
15
|
Walsh S, Donnan J, Fortin Y, Sikora L, Morrissey A, Collins K, MacDonald D. A systematic review of the risks factors associated with the onset and natural progression of epilepsy. Neurotoxicology 2017; 61:64-77. [DOI: 10.1016/j.neuro.2016.03.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 03/14/2016] [Indexed: 01/08/2023]
|
16
|
Maimburg RD, Olsen J, Sun Y. Neonatal hyperbilirubinemia and the risk of febrile seizures and childhood epilepsy. Epilepsy Res 2016; 124:67-72. [PMID: 27259071 DOI: 10.1016/j.eplepsyres.2016.05.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 02/05/2016] [Accepted: 05/17/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of the study was to estimate the association between newborn children treated with phototerapy for hyperbilirubinemia and the subsequent risk of febrile seizures or epilepsy in early childhood. METHODS We conducted a follow-up study of singleton children (N=70 230) born between February 1998 and May 2003 from the Danish National Birth Cohort (DNBC). Information on exposure to phototherapy for hyperbilirubinemia was obtained from a questionnaire in the DNBC. Information on epilepsy and febrile seizures were obtained from the Danish National Hospital Registry (DNHR). Cox proportional hazard regression model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CI). RESULTS Newborns treated with phototherapy for hyperbilirubinemia had a higher risk of developing epilepsy in early childhood (HR: 1.66, 95% CI: 1.23-2.24) but not febrile seizures (HR: 1.04, 95% CI: 0.86-1.27). The increases risk of epilepsy were only present for boys (HR: 1.98, 95% CI: 1.40-2.78) not for girls (HR: 1.14, 95% CI: 0.64-2.02) CONCLUSION: Phototherapy for hyperbilirubinemia in newborns was associated with an increased risk of epilepsy for males in early childhood. No excess risk was seen with febrile seizures.
Collapse
Affiliation(s)
- Rikke Damkjær Maimburg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Gynaecology and Obstetrics, Aarhus University Hospital, Skejby, Denmark; Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital, Aarhus, Denmark.
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Section of Epidemiology, School of Public Health, University of California at Los Angeles, CA, USA.
| | - Yuelian Sun
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
| |
Collapse
|
17
|
Impact of a rapid systemic guide on pediatric patients with suspicion of epilepsy. MEDICINA UNIVERSITARIA 2016. [DOI: 10.1016/j.rmu.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
18
|
Dereci S, Koca T, Akçam M, Türkyilmaz K. An Evaluation of Peripapillary Retinal Nerve Fiber Layer Thickness in Children With Epilepsy Receiving Treatment of Valproic Acid. Pediatr Neurol 2015; 53:53-7. [PMID: 25979661 DOI: 10.1016/j.pediatrneurol.2015.02.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 02/18/2015] [Accepted: 02/19/2015] [Indexed: 10/23/2022]
Abstract
AIM We investigated the peripapillary retinal nerve fiber layer thickness with optical coherence tomography in epileptic children receiving valproic acid monotherapy. MATERIALS AND METHODS The study was conducted on children aged 8-16 years who were undergoing valproic acid monotherapy for epilepsy. The study group comprised a total of 40 children who met the inclusion criteria and 40 healthy age- and sex-matched children as a control group. Children with at least a 1-year history of epilepsy and taking 10-40 mg/kg/day treatment were included in the study. Peripapillary retinal nerve fiber layer thickness measurements were performed using Cirrus HD optical coherence tomography. All children and parents were informed about the study and informed consent was obtained from the parents of all the participants. RESULTS The study group included 21 girls and 19 boys with a mean age of 10.6 ± 2.3 years. According to the results of optical coherence tomography measurements, the mean peripapillary retinal nerve fiber layer thickness was 91.6 ± 9.7 in the patient group and 95.5 ± 7.4 μm in the control group (P < 0.05). The superior peripapillary retinal nerve fiber layer thickness was 112.0 ± 13.2 in the patient group and 120.0 ± 14.7 μm in the control group (P < 0.02). According to the results of both measurements, the peripapillary retinal nerve fiber layer thickness was significantly lower in the patient group. Neither color vision loss nor visual field examination abnormality could be documented. CONCLUSION According to the optical coherence tomography measurements, the average and superior peripapillary retinal nerve fiber layer thicknesses were thinner in patients with epilepsy who were receiving valproic acid monotherapy compared with healthy children. This situation can lead to undesirable results in terms of eye health. New studies are needed to investigate whether these findings are the result of epilepsy or can be attributed to valproic acid and whether there are adverse effects of valproic acid later in life.
Collapse
Affiliation(s)
- Selim Dereci
- Department of Pediatrics, School of Medicine, S. Demirel University, Isparta, Turkey.
| | - Tuğba Koca
- Department of Pediatrics, School of Medicine, S. Demirel University, Isparta, Turkey
| | - Mustafa Akçam
- Department of Pediatrics, School of Medicine, S. Demirel University, Isparta, Turkey
| | - Kemal Türkyilmaz
- Department of Ophthalmology, School of Medicine, RTE University, Rize, Turkey
| |
Collapse
|
19
|
Consanguinity and epilepsy in Oran, Algeria: A case-control study. Epilepsy Res 2015; 111:10-7. [PMID: 25769368 DOI: 10.1016/j.eplepsyres.2014.12.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/27/2014] [Accepted: 12/30/2014] [Indexed: 01/23/2023]
Abstract
PURPOSE The goal of this case-control study was to identify the significance of consanguinity and other risk factors for epilepsy in Oran, Algeria. METHODS Unrelated epileptic patients upwards of 16 years, who attended the Neurology Department between October 2013 and March 2014 were included in the study. Controls, matched for age and sex, were selected among non-epileptic patients attending the same department during the same period. The risk factors evaluated were: consanguinity, family history of epilepsy, perinatal complications, infection of the central nervous system, mental retardation, neurological impairment, history of febrile seizures, severe head trauma, cerebrovascular diseases, and addiction. RESULTS 101 cases and 202 controls participated in the study. Multivariate logistic regression identified five factors significantly associated with epilepsy: first-degree of consanguinity (odds ratio (OR)=2.15), history of epilepsy in first-degree relatives (OR=4.03), antecedent of febrile seizures (OR=5.38), severe head injury (OR=2.94) and mental retardation (OR=9.32). CONCLUSION Consanguinity, family history of epilepsy, history of febrile seizures, severe head trauma and mental retardation are risk factors for epilepsy. The implementation of a strategy for prevention and awareness of the impact of consanguineous marriages as well as genetic counseling for couples with a family history of epilepsy are needed.
Collapse
|
20
|
Irimia A, Van Horn JD. Epileptogenic focus localization in treatment-resistant post-traumatic epilepsy. J Clin Neurosci 2014; 22:627-31. [PMID: 25542591 DOI: 10.1016/j.jocn.2014.09.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/16/2014] [Accepted: 09/21/2014] [Indexed: 11/15/2022]
Abstract
Pharmacologically intractable post-traumatic epilepsy (PTE) is a major clinical challenge for patients with penetrating traumatic brain injury, where the risk for this condition remains very high even decades after injury. Although over 20 anti-epileptic drugs (AED) are in common use today, approximately one-third of epilepsy patients have drug-refractory seizures and even more have AED-related adverse effects which compromise life quality. Simultaneously, there have been repeated recommendations by radiologists and neuroimaging experts to incorporate localization based on electroencephalography (EEG) into the process of clinical decision making regarding PTE patients. Nevertheless, thus far, little progress has been accomplished towards the use of EEG as a reliable tool for locating epileptogenic foci prior to surgical resection. In this review, we discuss the epidemiology of pharmacologically resistant PTE, address the need for effective anti-epileptogenic treatments, and highlight recent progress in the development of noninvasive methods for the accurate localization of PTE foci for the purpose of neurosurgical intervention. These trends indicate the current emergence of promising methodologies for the noninvasive study of post-traumatic epileptogenesis and for the improved neurosurgical planning of epileptic foci resection.
Collapse
Affiliation(s)
- Andrei Irimia
- The Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, 2001 North Soto Street, SSB1-102, Los Angeles, CA 90032, USA
| | - John Darrell Van Horn
- The Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, 2001 North Soto Street, SSB1-102, Los Angeles, CA 90032, USA.
| |
Collapse
|
21
|
Canpolat M, Kumandas S, Poyrazoglu HG, Gumus H, Elmali F, Per H. Prevalence and risk factors of epilepsy among school children in Kayseri City Center, an urban area in Central Anatolia, Turkey. Seizure 2014; 23:708-16. [PMID: 24939524 DOI: 10.1016/j.seizure.2014.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/21/2014] [Accepted: 05/24/2014] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To investigate the prevalence of epilepsy in schoolchildren aged 7-17 in the province of Kayseri together with the accompanying risk factors. METHODS Ten thousand individuals selected using the "stratified cluster sampling method" from a total population of 259,428 students within the borders of Kayseri city center constituted the study sample. A questionnaire was prepared in line with the epidemiological studies protocol recommended by the International Epilepsy Union Epidemiology and Prognosis Committee in 1993. Data were analyzed on IBM SPSS Statistics 20. Significance was set at p<0.05. RESULTS Of the 15,000 questionnaires distributed, 72% (n=10,742) were returned fully completed. Eighty-three students had been or were still being monitored with a diagnosis of epilepsy. The raw prevalence of epilepsy was 6/1000 in females, 9/1000 in males and 8/1000 in both groups together. Prevalence of active epilepsy was 4/1000 in females, 7/1000 in males and 6/1000 in both groups together. Premature birth increased the risk of epilepsy 2.6 times, and average and poor family income levels increased the risk of epilepsy 3.3 and 1.6 times, respectively. A history of febrile convulsion increased the risk of epilepsy 15.1 times. CONCLUSION The prevalence of epilepsy in the 7-17 age group in Kayseri is closer to that in developed rather than developing countries. We conclude that the risk factors for epilepsy, and particularly febrile convulsion, and the true prevalence rates need to be determined through studies involving wide socioeconomic strata.
Collapse
Affiliation(s)
- Mehmet Canpolat
- Erciyes University Medical School, Department of Pediatrics, Division of Pediatric Neurology, Talas, Kayseri, Turkey
| | - Sefer Kumandas
- Erciyes University Medical School, Department of Pediatrics, Division of Pediatric Neurology, Talas, Kayseri, Turkey
| | - Hatice Gamze Poyrazoglu
- Erciyes University Medical School, Department of Pediatrics, Division of Pediatric Neurology, Talas, Kayseri, Turkey
| | - Hakan Gumus
- Erciyes University Medical School, Department of Pediatrics, Division of Pediatric Neurology, Talas, Kayseri, Turkey
| | - Ferhan Elmali
- Erciyes University Medical School, Department of Biostatistics, Talas, Kayseri, Turkey
| | - Huseyin Per
- Erciyes University Medical School, Department of Pediatrics, Division of Pediatric Neurology, Talas, Kayseri, Turkey.
| |
Collapse
|
22
|
Ogunrin OA, Obiabo OY, Obehigie E. Risk factors for epilepsy in Nigerians - a cross-sectional case-control study. Acta Neurol Scand 2014; 129:109-13. [PMID: 24127647 DOI: 10.1111/ane.12192] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The identification of risk factors that predispose to development of epilepsy is crucial to its primary prevention. This study evaluated the risks conferred by some predisposing factors. PATIENTS AND METHODS This cross-sectional analytical study assessed the relative contributions of various risk factors to development of epilepsy in 244 adult Nigerians with epilepsy compared with equal number of age- and sex-matched controls. Odds ratio and Fisher exact test were used to express significant association. RESULTS Birth asphyxia (OR 6.87), recurrent childhood febrile convulsions (OR 5.74), central nervous system (CNS) infections (OR 3.38), head trauma (OR 1.82), rural dwelling without health care access (OR 2.44), and history of epilepsy in first-degree relatives (OR 3.44) were identified as significant risk factors for epilepsy. CONCLUSIONS Prompt diagnosis and appropriate treatment for febrile diseases and CNS infections, use of head helmets and car seat belts would contribute to reduced incidence.
Collapse
Affiliation(s)
- O. A. Ogunrin
- Neurology Unit; Department of Medicine; University of Benin Teaching Hospital; Benin City Nigeria
| | - O. Y. Obiabo
- Neurology Unit; Department of Medicine; University of Benin Teaching Hospital; Benin City Nigeria
| | - E. Obehigie
- Neurology Unit; Department of Medicine; University of Benin Teaching Hospital; Benin City Nigeria
| |
Collapse
|
23
|
Huseyinoglu N, Ozben S, Arhan E, Palanci Y, Gunes N. Prevalence and risk factors of epilepsy among school children in eastern Turkey. Pediatr Neurol 2012; 47:13-8. [PMID: 22704010 DOI: 10.1016/j.pediatrneurol.2012.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 04/09/2012] [Indexed: 11/29/2022]
Abstract
Epilepsy is a serious chronic brain disorder of childhood. We performed a cross-sectional prevalence study, determined the prevalence of childhood epilepsy, and identified the significance of certain risk factors for epilepsy among 1625 primary-school students aged 6-14 years, living in the center of Kars province. A questionnaire was prepared according to the definitions and principles of the Commission on Epidemiology and Prognosis, International League Against Epilepsy. Twenty-two children were diagnosed as epileptic. The point prevalence of active epilepsy in males was 4.9/1000, and in females 12.4/1000, representing a total of 8.6/1000. The cumulative prevalence in males was 11.0/1000, and 16.1/1000 in females, representing a total of 13.5/1000. Febrile convulsions, family history of epilepsy, serious maternal illness during pregnancy, a history of head trauma, antenatal/postnatal problems, and a history of neonatal jaundice were statistically significantly related to the development of epilepsy.
Collapse
Affiliation(s)
- Nergiz Huseyinoglu
- Department of Neurology, Medical Faculty, Kafkas University, Kars, Turkey.
| | | | | | | | | |
Collapse
|
24
|
Soria C, Escolano S, El Sabbagh S, Chmura S, Bulteau C, Chiron C, Dellatolas G. Behavioral problems, cognitive difficulties and quality of life in children with epilepsy: An analysis of parental concerns. Child Neuropsychol 2012; 18:209-27. [DOI: 10.1080/09297049.2011.602012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
25
|
Abstract
Febrile convulsion (FC) is the most common neurological disease in children. Cases with seizures that persist for more than 15 minutes or recurrent seizures within the same febrile illness are considered to be atypical and may have a different prognosis. Neuropeptide Y (NPY), an endogenous anticonvulsant that is widely distributed throughout the central nervous system, including the hippocampus, is known to prevent seizures by increasing the seizure threshold. Based on our previously finding that patients with atypical FC have lower concentrations of NPY, we hypothesized that the concentration of NPY may play a role in the development of atypical FC. To investigate this hypothesis, we used a radioimmunoassay to measure the plasma NPY concentration of 60 children with FC (typical FC, n = 46; atypical FC, n = 14) and 56 age-matched controls. The atypical FC group had significantly lower concentrations of NPY than children with typical FC and controls (66.47 +/- 19.11 pmol/L vs. 88.68 +/- 28.50 pmol/L and 86.82 +/- 22.66 pmol/L, respectively). Very low NPY levels were found in two patients; one patient (NPY level: 44.75 pmol/L) experienced prolonged seizures lasting for up to 1 hour and the other had recurrent seizures (three seizures) during the same febrile illness (NPY level: 33.53 pmol/L). These results suggest that patients with inadequate NPY inhibitory activity are more susceptible to atypical FC.
Collapse
|
26
|
Sampaio LPB, Caboclo LOSF, Kuramoto K, Reche A, Yacubian EMT, Manreza MLG. Prevalence of epilepsy in children from a Brazilian area of high deprivation. Pediatr Neurol 2010; 42:111-7. [PMID: 20117747 DOI: 10.1016/j.pediatrneurol.2009.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 04/29/2009] [Accepted: 09/02/2009] [Indexed: 10/20/2022]
Abstract
This study assessed the prevalence rate of epilepsy and its causes in children and adolescents in one area of high deprivation in São Paulo, São Paulo, in Southeast Brazil. Between July 2005 and June 2006, 4947 families from a population of 22,013 inhabitants (including 10,405 children and adolescents between the ages of 0 and 16 years) living in the shantytown of Paraisópolis, were interviewed. In the first phase, a validated questionnaire was administered, to identify the occurrence of seizures. In the second phase, clinical history, neurologic examination, electroencephalography, and structural neuroimaging were performed. The diagnosis of epilepsy, including etiology, seizure types, and epileptic syndrome classification, was according to criteria of the International League Against Epilepsy. The screening phase identified 353 presumptive cases. In the second phase, 101 of these cases (33.8%) received the diagnosis of epilepsy. Crude prevalence of epilepsy was 9.7/1000 and prevalence of active epilepsy was 8.7/1000. Partial seizures were the most frequent seizure type (62/101). Symptomatic focal epilepsy was the most common form, and hypoxic-ischemic encephalopathy the most common etiology, reflecting the socioeconomic conditions of this specific population. Adequate public policies regarding perinatal assistance could help reduce the prevalence of epilepsy.
Collapse
Affiliation(s)
- Letícia P B Sampaio
- Department of Neurology, Hospital of the Clinics of the Faculty of Medicine, University of São Paolo, São Paolo, SP, Brazil.
| | | | | | | | | | | |
Collapse
|