Clinico-epidemiological study of epilepsy in the first three years of life among children attending the Alexandria university Children's hospital during one year

ABSTRACT

The study is aimed at defining the patterns and possible risk factors of childhood epilepsy in the first three years of life. All children with epilepsy aged 29 days to three years attending Epilepsy Follow up Outpatient Clinic at Alexandria University Children's hospital [Alexandria. Egypt] from January 1st to December 31st 2000 were included. The eligible population was 182. Controls included an equal number of age and sex matched children. The records of children were retrieved and analyzed with a specially designed software program. The study revealed a significant difference between cases and controls regarding family socioeconomic profile, parental consanguinity, and family history of epilepsy, pre-natal and neonatal risk factors and home deliveries. Regarding post-natal factors, meningitis, encephalitis, significant head trauma, status epileptics [febrile or febrile], post-pertussis problems and febrile convulsions were significant. With regard to the epilepsy profile, generalized seizures were more common [80.2%]. Most had a single seizure type [85.7%]. Abnormal neurological findings occurred in 132 children [72.5%]. Abnormal inter-ictal EEG findings were found in 166 cases [91.2%]. Abnormal CT findings were found in 175 cases [87%]. Symptomatic epilepsy accounted for the majority of cases [106 children-58,2%], Epileptic syndromes were identified in 29 children [15.6%]. The most common one was West syndrome. With regard to treatment, the most commonly used drugs were carbamazepine and valproate. Monotherapy was the rule in 86.8%of cases. Regarding partial seizures, secondarily generalized seizures were the most responsive to treatment Absence seizures were the most responsive type of generalized seizures. There are well-defined significant risk factors in the first three years of life. Socioeconomic factors play an important role for the frequency of epilepsy especially in developing countries. Peculiar seizure types, epilepsy types and syndromes are more frequent in this age group