BMJ 1998;316:339-342 (31 January)

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

Zarrina Kurtz, senior lecturer,a Pat Tookey, research fellow,a Euan Ross, professor b

a Department of Epidemiology and Public Health, Institute of Child Health, University College London Medical School, London WC1N 1EH, b Department of Community Paediatrics, King’s College School of Medicine and Dentistry, London SE11 4QW

Correspondence to: Ms Tookey p.tookey@ich.ucl.ac.uk

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.

Key messages

  • 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


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