The Prevalence and Incidence of Convulsive Disorders in Children

Abstract

Each year, about 150,000 children and adolescents in the United States will come to medical attention for evaluation of a newly occurring seizure disorder of some type. Between 2% and 4% of all children in Europe and the United States experience at least one convulsion associated with a febrile illness before the age of 5 years. The cumulative incidence of febrile convulsions among children ranges from about 1% in China to more than 8% in Japan and 14% in Guam. The peak incidence of a first febrile convulsion occurs in the second year of life. Between 0.5% and 1% of children and adolescents experience a seizure associated with other acute metabolic or neurologic insults; most of these occur in the neonatal period. The incidence of epilepsy (recurrent unprovoked seizures) in children and adolescents seems relatively consistent across all populations studied, ranging from 50 to 100/100,000. The highest incidence of epilepsy is in the first year of life. West syndrome accounts for about 2% of all childhood epilepsy. Lennox-Gastaut syndrome for 1-2%, childhood absence epilepsy (pyknolepsy) for 10-15%, juvenile myoclonic epilepsy for 5%, and idiopathic localization-related epilepsy for 10%. Between 0.5 and 1% of children experience a nonrecurrent, single, unprovoked convulsive episode. Following are the estimated numbers of children and adolescents with newly diagnosed convulsive disorders in the United States for the year 1990: febrile seizures, 100,000; neonatal seizures, 4,000; other provoked seizures, 6,000; single unprovoked seizures, 10,000; and epilepsy, 30,000.

Temperament, family environment, and behavior problems in children with new-onset seizures

“…1 Raw scores were used for the TRF in the analyses. Using standardized T-scores can reduce the range of scores because children with different raw scores can have the same T-score; raw scores preserve this sample variability.…”

“…Epilepsy is one of the most common neurological disorders in children and adolescents, affecting 3-5% at some time in their lives [1]. Children with epilepsy have been shown to be at increased risk for psychopathology [2,3] as well as for problems with adjustment, including behavior, and cognition [4][5][6][7][8][9].…”

Neuropeptide Y: Potential role in recurrent developmental seizures

“…However, most FS (affecting 2-14% of all children worldwide; [46,71 for review]) do not lead to epilepsy, and certain risk factors have been distinguished. These include: 1) FS that are prolonged, i.e., >10 to 15 min [3,16,56], 2) FS that are recurrent, i.e., several seizures within a 24h period [3,55], and 3) FS that are focal.…”

“…In this model, experimental FS are induced in rat pups on postnatal days 10 or 11, an age that corresponds to the hippocampal developmental stage at which human infants are most susceptible to febrile seizures (see comparison of developmental milestones in humans and rodent hippocampus in [4]). The majority of FS in humans occur between 6 months and 5 years of age with a peak of incidence at 18 months [46,57].…”

No association between ApoE polymorphism and febrile seizures

“…In humans, the highest incidence of seizures is in the first 2 years of life and is most often associated with a febrile illness [14]. Fever begins with the activation of immune response cells that produce interleukin-1, which in turn increases prostaglandin E2 synthesis [15].…”