Occurrence and outcome of epilepsy in children younger than 2 years.

Abstract

To analyze the occurrence of epilepsy between the ages of 28 days and 2 years and the outcome of children with the onset of epilepsy at that age. The study included all children who were born between January 1, 1976, and December 31, 1986, in an area with a mean annual live birth rate of 5027 and who were treated for epilepsy at that age. Follow-up data were gathered from medical records and/or with a questionnaire. By age 2 years, 72 children had epilepsy, giving a cumulative incidence rate of 1.3 cases per 1000 children (95% CI, 1.0-1.6). Thirty-two (97.0%) of the 33 children with cryptogenic epilepsy were without medication at the time of the last visit and had been in remission for a mean period of 13.0 years (range, 7.4-19.7 years), in contrast to only 5 (15.6%) of the 32 children with symptomatic epilepsy (difference, 81.3%; 95% CI of the difference, 63.0%-91.3%; P <.0001). In the logistic regression model, the type of the epilepsy (symptomatic/cryptogenic) was the only variable that explained the persistence of epilepsy during the follow-up (P <.05). Thirty-one (93.9%) of the 33 children with cryptogenic epilepsy were mentally normal, as opposed to only 3 (9.4%) of the 32 children with symptomatic epilepsy (difference 84. 6%; 95% CI of the difference, 66.3%-93.4%; P <.0001). The outcome of children whose epilepsy starts between the ages of 28 days and 2 years is determined by the underlying brain disease, and the outcome is good in cryptogenic cases.