SAN DIEGO – Nearly one-third of children with epilepsy had neurodevelopmental problems at the onset of unprovoked seizures, results from a large registry study found.
The finding supports the notion that seizures "often appear as part of a broader neurological problem, and that in most cases comorbidities should not be considered consequences of the seizure disorder," researchers led by Dr. Eva Andell wrote in a poster presented at the annual meeting of the American Epilepsy Society.
Dr. Eva Andell
Dr. Andell, a pediatrician at Karolinska University, Stockholm, and her associates analyzed data from the Stockholm Incidence Register of Epilepsy, a surveillance system established in 2001 with the intent to identify incident cases of first unprovoked seizures and epilepsy among residents of Northern Stockholm.
The researchers limited their analysis to medical records from the time of first unprovoked seizure and the following 6 months among 766 children aged 0-18 years who were followed through Dec. 31, 2006, and set out to identify potential comorbidities that included developmental delay, language problems, mental retardation, cerebral palsy, autism spectrum disorders, attention-deficit/hyperactivity disorder (ADHD), and psychiatric diagnoses.
"Comorbidities were considered to be present when a relevant defined diagnosis appeared in the medical records or when the records included a clear problem description highly suggestive of a comorbidity," the researchers explained in their abstract.
Of the 766 children, 247 (32%) had one or two of the defined comorbidities at the time of the first recognized seizure or in the following 6 months. Of these, 87 (11%) were diagnosed with, or suspected to have two or more of the following diagnoses: mental retardation, cerebral palsy, autism spectrum disorders, ADHD, and psychiatric diagnoses.
The prevalence of all studied comorbidities was more common in the seizure cohort compared with reported rates in the general pediatric population, especially mental retardation (16% vs. 3%, respectively), cerebral palsy (9% vs. 0.2%), autism spectrum disorders (7% vs. 1%), and ADHD (6% vs. 5%).
In an interview, Dr. Andell advised clinicians to "not to forget to look into whether children with epilepsy have a comorbidity, and to treat the comorbidity as well."
Dr. Andell said she had no relevant financial conflicts to disclose.