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. 2022 Aug;63(8):2096-2107.
doi: 10.1111/epi.17314. Epub 2022 Jun 25.

Outcome at age 7 of epilepsy presenting in the first 2 years of life. A population-based study

Tommy Stödberg  1   2 , Torbjörn Tomson  3 , Britt-Marie Anderlid  4   5 , Tomas Andersson  6   7 , Olivia Henry  4 , Per Åmark  1 , Anna Wedell  4   8
Affiliations

Outcome at age 7 of epilepsy presenting in the first 2 years of life. A population-based study

Tommy Stödberg et al. Epilepsia. 2022 Aug.

Abstract

Objective: Existing data suggest that epilepsy presenting in the first few years of life carries a worse prognosis than later onset. However, studies are few and methods differ, making interpretations of data uncertain. This study analyzes outcome at age 7 and potential prognostic factors in a well-characterized population-based cohort with epilepsy onset during the first 2 years of life.

Methods: An incidence cohort of 116 prospectively identified cases of epilepsy with seizure onset before age 2 years was described in Stödberg et al. (2020). Cases were originally retrieved from the Stockholm Incidence Registry of Epilepsy (SIRE), which registered all cases with a first unprovoked epileptic seizure from September 1, 2001, in Northern Stockholm. Data on treatment and outcome at age 7 years were collected from electronic medical records and through interviews with parents. Outcome and potential prognostic factors were analyzed with descriptive statistics and multivariable log binomial regression analysis.

Results: Eleven children (9.5%) died before age 7. Polytherapy was common. Epilepsy surgery was performed in two children. At age 7 years, 61 of 116 children (53%) had been seizure-free for the last 2 years or longer. Intellectual disability was diagnosed in 57 of 116 children (49%), autism spectrum disorder in 13 (11%), and cerebral palsy in 28 (24%). West syndrome had a similar seizure remission rate but a worse cognitive outcome. There was no difference in outcome between first and second year onset. Six predictors, including etiology, remained associated with two or more outcome variables after regression analysis.

Significance: About half of children with infantile-onset epilepsy will become seizure-free and half of them will have intellectual disability. Etiology was confirmed as a major independent predictor of outcome. Our study contributes to a more firm knowledge base when counseling parents of infants diagnosed with epilepsy.

Keywords: comorbidities; etiology; infantile epilepsy; outcome; seizure remission.

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Conflict of interest statement

Dr. Tomson reports speaker's honoraria to his institution from Eisai, Sanofi, Sun Pharmaceutical Industries Ltd, and UCB, and research support from Bial, Eisai, GlaxoSmithKline, Stockholm County Council, Teva, GW Pharma, Arvelle, and UCB. The remaining authors have no conflicts of interest. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

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