Prevalence of Childhood Epilepsy in Estonia

Authors


Address correspondence and reprint requests to Dr. A. Beilmann at Department of Pediatrics, The University of Tartu, Lunini str. 6, EE2400, Tartu, Estonia.

Abstract

Summary: Purpose: To establish the prevalence rate (PR) and main characteristics of childhood epilepsy in Estonia.

Methods: We performed a population-based case ascertainment of all the possible sources of medical care in seven counties of Estonia from January 1995 to December 1997. Only cases of patients from 1 month to 19 years of age with active epilepsy (i.e., at least one seizure during the last 5 years, regardless of treatment) were included. All patients were examined by a pediatric neurologist.

Results: Five hundred sixty cases met the study criteria on the prevalence day, December 31, 1997. The total PR was 3.6 per 1,000 population (boy/girl ratio, 1.2:1.0). The PR was the highest—4.3 per 1,000—in the 5-to-9-year-old age group. The prevalence declined markedly in children age 14 years and on. The correlation between age and PR was negative (-0.542, p < 0.0001) by regression analyses. The most frequent seizure types in the total group were primarily generalized seizures— PR 2.1/1,000 [rate ratio (RR) 1.4, 95% confidence interval (CI) 1.2, 1.6]. The predominance of generalized seizures was significant in those younger than 10 years. In 14.8% of cases, there was a history of epilepsy among first- and second-degree relatives. Benign rolandic epilepsy—PR 0.2/1,000—was the most frequent among idiopathic syndromes, and Lennox-Gastaut syndrome—PR 0.08/1,000—was the most frequent among cryptogenic ones. Perinatal factors—PR 0.8/1,000 were the most frequently found cause of epilepsy. In 304 cases (54.2%), additional medical problems existed.

Conclusions: The prevalence of childhood epilepsy was comparable with that found in developed countries. Generalized seizures predominated, and the main cause was perinatal factors.

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