Incidence of Epilepsies and Epileptic Syndromes Among Children in Navarre, Spain: 2002 Through 2005

Durá-Travé, Teodoro; Yoldi-Petri, María Eugenia; Gallinas-Victoriano, Fidel

doi:10.1177/0883073808314898

Cited by 46 publications

(37 citation statements)

References 24 publications

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“…• There is no high-level evidence to support any particular current agents for use in infants with seizures. Overall, infantile (epileptic) spasms constitute the largest single epilepsy subgroup, representing 13-45.5% of infantile population-based incidence studies 44,47,[52][53][54][55][56] For other seizure types there are limited data beyond case series (class 3 and 4 studies) The outcomes reported in typically class 4 studies suggest that seizures in infancy are predictive of comorbidities as well as complex and poor outcomes 52,53,55 Clinical semiology/ types of epileptic events…”

Section: Methodsmentioning

confidence: 99%

Summary of recommendations for the management of infantile seizures: TaskForceReport for theILAE Commission ofPediatrics

et al. 2015

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Summary Evidence‐based guidelines, or recommendations, for the management of infants with seizures are lacking. A Task Force of the Commission of Pediatrics developed a consensus document addressing diagnostic markers, management interventions, and outcome measures for infants with seizures. Levels of evidence to support recommendations and statements were assessed using the American Academy of Neurology Guidelines and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The report contains recommendations for different levels of care, noting which would be regarded as standard care, compared to optimal care, or “state of the art” interventions. The incidence of epilepsy in the infantile period is the highest of all age groups (strong evidence), with epileptic spasms the largest single subgroup and, in the first 2 years of life, febrile seizures are the most commonly occurring seizures. Acute intervention at the time of a febrile seizure does not alter the risk for subsequent epilepsy (class 1 evidence). The use of antipyretic agents does not alter the recurrence rate (class 1 evidence), and there is no evidence to support initiation of regular antiepileptic drugs for simple febrile seizures (class 1 evidence). Infants with abnormal movements whose routine electroencephalography (EEG) study is not diagnostic, would benefit from video‐EEG analysis, or home video to capture events (expert opinion, level U recommendation). Neuroimaging is recommended at all levels of care for infants presenting with epilepsy, with magnetic resonance imaging (MRI) recommended as the standard investigation at tertiary level (level A recommendation). Genetic screening should not be undertaken at primary or secondary level care (expert opinion). Standard care should permit genetic counseling by trained personal at all levels of care (expert opinion). Genetic evaluation for Dravet syndrome, and other infantile‐onset epileptic encephalopathies, should be available in tertiary care (weak evidence, level C recommendation). Patients should be referred from primary or secondary to tertiary level care after failure of one antiepileptic drug (standard care) and optimal care equates to referral of all infants after presentation with a seizure (expert opinion, level U evidence). Infants with recurrent seizures warrant urgent assessment for initiation of antiepileptic drugs (expert opinion, level U recommendation). Infantile encephalopathies should have rapid introduction and increment of antiepileptic drug dosage (expert opinion, level U recommendation). There is no high level evidence to support any particular current agents for use in infants with seizures. For focal seizures, levetiracetam is effective (strong evidence); for generalized seizures, weak evidence supports levetiracetam, valproate, lamotrigine, topiramate, and clobazam; for Dravet syndrome, strong evidence supports that stiripentol is effective (in combination with valproate and clobazam), whereas weak evidence supports that topiramate, zonisamide,...

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Section: Methodsmentioning

confidence: 99%

Summary of recommendations for the management of infantile seizures: TaskForceReport for theILAE Commission ofPediatrics

et al. 2015

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“…Muitos estudos prévios sobre a prevalência e a incidência de epilepsia já foram publicados, com resultados variando de 0,9 a 57 casos por 1.000 habitantes para a prevalência, e 26 a 190 casos por 100.000 habitantes para a incidência [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] . Muitas dessas variações ocorreram devido a diferenças metodológicas, como definição de epilepsia, critérios diagnósti-cos, ou avaliação prospectiva ou retrospectiva dos dados 27 .…”

Section: Discussionunclassified

“…Foi observada uma predominância de epilepsia idiopática, em relação à epilepsia sintomática (64%), resultados semelhantes a relatos pré-vios 8,12,13 . No entanto, outros autores observaram uma predominância de epilepsia criptogênica e/ou sintomática 2,3,6,7,14,15 . As diferenças entre os estudos podem ser decorrentes do fato de que alguns casos não puderam ser classificados pelas categorias detalhadas da classificação da ILAE 28 .…”

Section: Discussionunclassified

“…Em estudos prévios focados somente na população infantil, alguns autores relataram uma predominância da epilepsia focal 2,3,5,8,[11][12][13][14] , e outros da generalizada 6,7,9,10,15 , como em nosso estudo.…”

Section: Discussionunclassified

“…Muitos estudos avaliando a prevalência de epilepsia estão disponíveis na literatura, mas poucos estimaram a incidência de epilepsia em uma população específica de crianças [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] .…”

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Incidence of epilepsy and seizure disorders in childhood and association with social determinants: a birth cohort study

Nunes

Geib²,

Apego³

2011

J Pediatr (Rio J)

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Objective: To investigate the incidence and prevalence of epilepsy and seizure disorders during childhood, and their relationship to selected social determinants. Methods:Population-based birth cohort study, with children born between January 1st and December 31st, 2003 in the city of Passo Fundo (RS), Brazil. Data was prospectively collected in two stages. In the first one, the Questionnaire of Neurologic Tracking for Epilepsy (QNT-E) was applied at the children's homes, together with the assessment of social determinants of health. Constructs of social position (economical class, mother's educational level, marital status and occupation), biological and behavioral factors (alcohol and tobacco consumption during pregnancy, number of prenatal appointments, and use of medicines during pregnancy), and psychosocial factors (religious meetings attendance) were analyzed. In the second stage, children with a positive QNT-E were submitted to neuroclinical assessment for diagnostic confirmation.Results: Eleven cases of epilepsy, 27 of febrile seizures, 10 of neonatal seizures, 8 of single seizures, besides 26 patients with nonepileptic paroxysmal events, were identified. The incidence rate of epilepsy was 7/100,000 children and the prevalence 65.2/10,000 children. Nine children had active epilepsy, giving a point prevalence of 53.3/10,000 children. After multivariate analysis, no social determinants could be significantly related to epilepsy. Conclusions:In this study, a low incidence rate of epilepsy was reported in contrast to almost a double incidence of febrile seizures and non-epileptic paroxysmal events. Moreover, the achievement of an accurate diagnosis of epilepsy in developing countries is still a challenge, in order to avoid misdiagnosis.J Pediatr (Rio J). 2011;87(1):50-56: Epilepsy, epileptic syndromes, incidence, prevalence, childhood. ResumoObjetivo: Investigar a incidência e prevalência de epilepsia e distúrbios convulsivos na infância e sua relação com os determinantes sociais escolhidos.Métodos: Estudo de coorte de nascimento de base populacional, com crianças nascidas entre 1/01 e 31/12/2003 na cidade de Passo Fundo (RS). Os dados foram coletados prospectivamente em duas etapas. Na primeira, foi aplicado o Questionário de Rastreamento Neurológico para Epilepsia (QRN-E) durante uma visita à casa das crianças, juntamente com a avaliação dos determinantes sociais da saúde. Foram analisados construtos de posição social (classe econômica, escolaridade, estado civil e ocupação da mãe), fatores biológicos e comportamentais (consumo de álcool, tabaco e medicamentos na gravidez, e consultas pré-natais) e fatores psicológicos (participação em cerimônias religiosas). Na segunda etapa, as crianças cujos QRN-E apresentaram resultado positivo foram submetidas a avaliação neuroclínica para confirmação do diagnóstico. Resultados:Foram identificados 11 casos de epilepsia, 27 de convulsões febris, 10 de convulsões neonatais, 8 de crise única, além de 26 pacientes com eventos paroxísticos não epilépticos. A incidê...

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Management practices for West syndrome in South Asia: A survey study and meta‐analysis

Madaan

Chand

Linn³

et al. 2020

Epilepsia Open

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Objectives Considering the dearth of literature on West syndrome (WS) from South Asian countries, this study aimed to evaluate the management practices in South Asia by an online survey and meta‐analysis. Methods An online questionnaire was sent to 223 pediatric neurologists/pediatricians in India, Pakistan, Myanmar, Sri Lanka, Bhutan, Nepal, and Bangladesh. Their responses were evaluated and supplemented by a meta‐analysis. Results Of 125 responses received (response rate: 56%), around 60% of responders observed male preponderance and an approximate lead‐time‐to‐treatment (LTTT) of 4‐12 weeks. The commonest etiology observed was a static structural insult (88.6% of responders). Most commonly used first‐line drug (country‐wise) was as follows: India—adrenocorticotropin hormone (ACTH, 50%); Pakistan—oral steroids (45.5%); Myanmar, Sri Lanka, and Nepal—oral steroids (94.4%); Bangladesh—ACTH (2/2); Bhutan—vigabatrin (3/5). ACTH and vigabatrin are not available in Myanmar and Nepal. The most commonly used regime for ACTH was maximal‐dose‐at‐initiation‐regime in India, Sri Lanka, and Bangladesh and gradually escalating‐regime in Pakistan. Maximum dose of prednisolone was variable—most common response from India: 3‐4 mg/kg/d; Pakistan, Bhutan, and Bangladesh: 2 mg/kg/d; Sri Lanka, Nepal, and Myanmar: 5‐8 mg/kg/d or 60 mg/d. The total duration of hormonal therapy (including tapering) ranged from 4 to 12 weeks (67/91). Most responders considered cessation of spasms for four weeks as complete response (54/111) and advised electroencephalography (EEG; 104/123) to check for hypsarrhythmia resolution. Difficult access to pediatric EEG in Bhutan and Nepal is concerning. More than 95% of responders felt a need for more awareness. The meta‐analysis supported the preponderance of male gender (68%; confidence interval [CI]: 64%‐73%), structural etiology(80%; CI 73%‐86%), longer LTTT (2.4 months; CI 2.1‐2.6 months), and low response rate to hormonal therapy(18% and 28% for ACTH and oral steroids respectively) in WS in South Asia. Significance This study highlights the practices and challenges in the management of WS in South Asia. These include a preponderance of male gender and structural etiology, a longer LTTT, difficult access to pediatric EEG, nonavailability of ACTH and vigabatrin in some countries, and low effectiveness of hormonal therapy in this region.

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Incidence of Epilepsies and Epileptic Syndromes Among Children in Navarre, Spain: 2002 Through 2005

Cited by 46 publications

References 24 publications

Summary of recommendations for the management of infantile seizures: TaskForceReport for theILAE Commission ofPediatrics

Summary of recommendations for the management of infantile seizures: TaskForceReport for theILAE Commission ofPediatrics

Incidence of epilepsy and seizure disorders in childhood and association with social determinants: a birth cohort study

Management practices for West syndrome in South Asia: A survey study and meta‐analysis

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