Epilepsy in young people: 23 year follow up of the british national child development study

Abstract

Objective: To estimate the incidence and prevalence of epilepsy during childhood and early adult life in England, Scotland, and Wales. Design: Prospective study of 17 414 children born in England, Scotland, and Wales between 3 and 9 March 1958, followed up at 7, 11, 16, and 23 years of age, with a review of those with epilepsy at age 28. Subjects: People with epilepsy developing at or before age 23. Main outcome measures: The age specific incidence, cumulative incidence, and prevalence of epilepsy. Results: 124 young people had a confirmed diagnosis of epilepsy during their first 23 years (cumulative incidence 8.4 per 1000; 95% confidence interval 6.8 to 10.0). 6 had died by age 23. 46 (37%) had neurological impairment or another major health problem in addition to epilepsy. The prevalence of active epilepsy at age 23 was 6.3 per 1000 (4.9 to 7.7). Conclusions: A wide variety of seizure disorders is included under the term epilepsy. A third of cases had generalised seizures. In only a quarter was the onset of seizures attributed to a specific cause. Children with additional health problems were more likely to continue to have seizures in early adult life than those with epilepsy alone. 1 in 8 were prescribed drug treatment for 6 years or more after their last seizure. All deaths occurred in young adults over the age of 16. A cause of epilepsy was identified in only about a quarter of cases in the national child development study cohort 35% of those diagnosed with epilepsy by age 16 no longer require drug treatment and are free from seizures by age 23 30% of young people in this cohort continued taking drugs for epilepsy for more than 2 years after their last seizure; 15 of these young people had not had a seizure for 6 or more years Continuing epilepsy is more likely in those with neurological impairment or other additional medical conditions After age 16 there is a high death rate in young people with epilepsy. This emphasises the importance of maintaining supportive relationships between health care professionals and people with epilepsy as they become independent adults