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      Risk factors of childhood epilepsy in Kerala

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          Abstract

          Background:

          We aimed to identify the risk factors for epilepsy in children.

          Materials and Methods:

          This case–control retrospective study was carried out in the pediatric neurology outpatient service of the Trivandrum Medical College. All children (1–12 years) with epilepsy satisfying the selection criteria were included, after obtaining consent from parents. Those with single seizures or febrile seizures were excluded. Controls were children without epilepsy attending the same hospital. Parents were interviewed and clinical data were obtained from medical records. Statistical analysis included chi-square test, odds ratio (OR), and logistic regression.

          Results:

          There were 82 cases and 160 controls whose mean age was 6.9 + 3.6 and 5.2 + 3.1, years respectively. On univariate analysis, family history of epilepsy, prolonged labor, cyanosis at birth, delayed cry after birth, admission to newborn intensive care unit, presence of congenital malformations, neurocutaneous markers, incessant cry in the first week, delayed developmental milestones, meningitis, encephalitis, and head trauma were found to be significant. On logistic regression, family history of epilepsy (OR 4.7), newborn distress (OR 8.6), delayed developmental milestones (OR 12.6), and head trauma (OR 5.8) were found to be significant predictors. Infants who had history of newborn distress are likely to manifest epilepsy before 1 year if they are eventually going to have epilepsy (OR 3.4).

          Conclusion:

          Modifiable factors such as newborn distress and significant head trauma are significant risk factors for childhood epilepsy. Newborn distress is a risk factor for early-onset (<1 year age) epilepsy.

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          Most cited references22

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          Seizures after head trauma: a population study.

          A cohort of 2747 patients with head injuries was followed for 28,176 person-years to determine the magnitude and duration of the risk of posttraumatic seizures. Injuries were classified as severe (brain contusion, intracerebral or intracranial hematoma, or 24 hours of eight unconsciousness of amnesia), moderate (skull fracture or 30 minutes to 24 hours of unconsciousness or amnesia), and mild (briefer unconsciousness or amnesia). The risk of posttraumatic seizures after severe injury was 7.1% within 1 year and 11.5% in 5 years, after moderate injury the risk was 0.7 and 1.6%, and after mild injury the risk was 0.1 and 0.6%. The incidence of seizures after mild head injuries was not significantly greater than in the general population.
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            Epilepsy in young people: 23 year follow up of the British national child development study.

            To estimate the incidence and prevalence of epilepsy during childhood and early adult life in England, Scotland, and Wales. 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. People with epilepsy developing at or before age 23. The age specific incidence, cumulative incidence, and prevalence of epilepsy. 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). 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.
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              The prevalence and associated factors of epilepsy in children in Calicut District, Kerala, India.

              To determine the prevalence of epilepsy and its association with indices of malnutrition, infection and perinatal complications in children in Calicut District, Kerala, India, a door-to-door two-stage survey was conducted in two local government districts. Among the random sample of 1172 children aged 8-12 y, 26 conformed to the definition of epilepsy giving a 5-y period prevalence of 22.2/1000. A history of perinatal complications, low BMI and recent physical symptoms were independently associated with active epilepsy. The results suggest epilepsy is highly prevalent in this population of children and that further research is needed into its cause.
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                Author and article information

                Journal
                Ann Indian Acad Neurol
                AIAN
                Annals of Indian Academy of Neurology
                Medknow Publications & Media Pvt Ltd (India )
                0972-2327
                1998-3549
                Oct-Dec 2011
                : 14
                : 4
                : 283-286
                Affiliations
                [1]Department of Community Medicine, Government Medical College, Trivandrum, Kerala, India
                [1 ]Department of Pediatric neurology, Government Medical College, Trivandrum, Kerala, India
                Author notes
                For correspondence: Dr. Thomas Varghese Attumalil, 329 Bapuji Nagar, Medical College PO, Trivandrum - 695 011, Kerala, India. E-mail: thomas.vinay@ 123456gmail.com
                Article
                AIAN-14-283
                10.4103/0972-2327.91950
                3271468
                22346018
                248dfbc6-9ce7-49fc-899c-d87be147edc1
                Copyright: © Annals of Indian Academy of Neurology

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 December 2010
                : 08 March 2011
                : 16 May 2011
                Categories
                Short Communication

                Neurology
                epilepsy,risk factor,kerala
                Neurology
                epilepsy, risk factor, kerala

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