Birth Order in Epileptic Children

Abstract

A knowledge of birth order can be contributory to the evaluation of hereditary and environmental factors in disease. There is, however, no agreement as to whether a characteristic birth order pattern exists in epilepsy. Thus Brain (1956) and Lennox (1960) (1950) and Orr and Risch (1953) by their use of sibs of the reference epileptics as controls but here bias was possible to the extent that parents who have had an epileptic child might limit family size afterwards, causing such an epileptic to hold a relatively late birth order position in the family. METHOD OF ENQUIRYWith all these considerations in mind, the following method of enquiry was adopted. From the hospital records all patients diagnosed as epileptics were collected and follow-up enquiries on them conducted during 1957 and 1961. There were then selected for further investigation those who were either first born with a second born sib control, or second born with a first born sib control, and had suffered 10 or more 'convulsion days', a 'convulsion day' being defined as any day in which the patient had one or more convulsions. The first stipulation secured the advantages of Alstro.n's enquiry but placed bias on the epileptics of the enquiry series being second rather than first born, and the second stipulation excluded convulsions which were exclusively febrile and also slight, infrequent convulsions, so minimizing bias which might arise from the possible tendency of parents to be more worried by illnesses in first children, that is, the standard of severity adopted was such that the affected children were likely to have been referred for hospital investigation whatever their birth order. It remained to arrange that the sibs of each pair be observed for 59

Epileptic seizures induced by psychotropic drugs

“…Nielsen & Butler (1948) examined the case histories of 780 children with idiopathic epilepsy and found that the risk was almost twice as high in first born. This was confirmed by Colver & Kerridge (1961), but Cooper (1965), in a longitudinal study of 5000 children, was unable to find any relationship at all. The possible relevance of birth order to adult epilepsy does not seem to have been considered.…”

Studies on 782 Cases of Mental Deficiency Part V

“…Birth Rank. The high incidence of first born (40% ) is not statistically significant although it should be noted that a significantly raised incidence of first born was found by Nielsen (1946), Nielsen and Butler (1948), and Colver and Kerridge ( 1962). Pregnancy, labour, delivery, neonatal symptoms.…”

Is pregnancy order a factor in epilepsy?

“…Most recently, Colver and Kerridge (1962) reviewed some of the studies, difficulties, and controversies alluded to above, and, from their own data of 174 cases of central (21), focal (45), or undifferentiated (108) epileptics who had suffered 10 or more 'convulsion days' concluded that 'it has been established beyond reasonable doubt that epilepsy as defined above is more frequent in first than in second born children'. These investigators cautiously suggest that their results 'taken with the similar birth order differences among stillbirths and deaths in the first week of life are at least consistent with the hypothesis that these occurrences and epilepsy in childhood may have important causes in common'.…”