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Incidence and outcome of epilepsy syndromes with onset in the first year of life: A retrospective population‐based study
Author(s) -
Gaily Eija,
Lommi Markus,
Lapatto Risto,
Lehesjoki AnnaElina
Publication year - 2016
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13514
Subject(s) - epilepsy , pediatrics , etiology , medicine , incidence (geometry) , population , cohort , epilepsy syndromes , retrospective cohort study , cohort study , age of onset , generalized epilepsy , surgery , psychiatry , disease , physics , environmental health , optics
Summary Objective Population‐based studies on infantile epilepsy syndromes are scarce. Our aim was to provide syndrome‐specific data on the incidence and outcome of epilepsy in a population‐based cohort of infants with epilepsy onset in the first year. Methods Included were all infants born in 1997 through 2006 whose epileptic seizures started before 12 months of age and who were residents of the Helsinki University Hospital district at the time of seizure onset. Patients were ascertained from hospital statistics, and all patient charts were reviewed. A reevaluation of the epilepsy syndromes, age at onset, etiology, and outcome at 24 months of age was based on data abstracted from the patient files. Results Inclusion criteria were fulfilled by 158 infants, of whom 92% were followed until age 24 months or death. The incidence of epilepsy in the first year was 124 of 100,000. An epilepsy syndrome recognized by the revised organization of epilepsies by ILAE was identified in 58% of the patients. The most common syndromes were West syndrome (41/100,000) and benign familial or nonfamilial infantile epilepsy (22/100,000). Etiology was structural‐metabolic in 35%, genetic in 17%, and unknown in 48%. Early age at onset was associated with structural‐metabolic etiology. Seven infants (4.4%) died before age 2 years. One infant with an SCN 2A mutation died of sudden unexplained death in epilepsy ( SUDEP ). At 24 months, 58% of all children included in the cohort were seizure‐free, and 46% had both seizure freedom and age‐appropriate cognitive development. Age at onset was not associated with outcome when etiology was controlled for. Significance Benign familial and nonfamilial infantile epilepsy appears to be more common than previously suggested, second only to West syndrome. Early age at onset is not an independent risk factor for poor outcome.