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. 2017 Jan 19;2(1):76-83.
doi: 10.1002/epi4.12036. eCollection 2017 Mar.

Etiology, syndrome diagnosis, and cognition in childhood-onset epilepsy: A population-based study

Arja Sokka  1 , Päivi Olsen  2 , Jarkko Kirjavainen  1 , Maijakaisa Harju  3 , Leea Keski-Nisula  3 , Sari Räisänen  4 , Seppo Heinonen  5 , Reetta Kälviäinen  6
Affiliations

Etiology, syndrome diagnosis, and cognition in childhood-onset epilepsy: A population-based study

Arja Sokka et al. Epilepsia Open. .

Abstract

Objective: To evaluate the prevalence of various etiologies of epilepsies and epilepsy syndromes and to estimate cognitive function in cases of childhood-onset epilepsy.

Methods: A population-based retrospective registry study. We identified all medically treated children with epilepsy born in 1989-2007 in Finland's Kuopio University Hospital catchment area, combining data from the birth registry and the national registry of special-reimbursement medicines. We reevaluated the epilepsy diagnoses and syndromes and gathered data on etiologies and cognitive impairment.

Results: We identified 289 children with epilepsy. The annual incidence rate of epilepsies and epilepsy syndromes was 38 in 100,000, and the misdiagnosis rate was 3%. A specific etiology was identified in 65% of the cases, with a structural etiology accounting for 29% and a genetic or presumed genetic etiology for 32%. Most patients with unknown-etiology epilepsy had focal epilepsy and were of normal intelligence. Intellectual disability was detected in 35% of cases, and only 17% in this group had an unknown etiology for the epilepsy. Electroclinical syndromes (mainly West syndrome) were recognized in 35% of the patients.

Significance: Epilepsy is a complex disease that encompasses many etiologies and rare syndromes. The etiology and specific epilepsy syndrome are important determinants of the outcome and key factors in treatment selection. Etiological diagnosis can be achieved for the majority of children and syndromic diagnosis for only a third.

Keywords: Adolescence; Childhood; Classification; Cognition; Epilepsy; Epilepsy syndrome; Etiology; Intelligence; Pediatric; Prevalence.

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Figures

Figure 1
Figure 1
Flowchart of the data collection.
Figure 2
Figure 2
Distribution of epilepsy diagnosis by age separately for males and females.
Figure 3
Figure 3
Cognition in childhood‐onset epilepsy.
See this image and copyright information in PMC

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