title: The incidence of unprovoked seizures and occurrence of neurodevelopmental comorbidities in children at the time of their first epileptic seizure and during the subsequent six months.
abstract: OBJECTIVE
  To evaluate the incidence of unprovoked seizures in children and the prevalence of related neurodevelopmental comorbidities at the time of the presumed first seizure and six months thereafter.
  
  
  METHODS
  The medical records of all children (0-18 years of age) seeking medical attention as the result of a first unprovoked seizure between September 1, 2001 and December 31, 2006, and registered in the population-based Stockholm Incidence Registry of Epilepsy (SIRE) were reviewed. Neurodevelopmental comorbidities were evaluated on the basis of the medical records from this first visit and from other healthcare during the following six months.
  
  
  RESULTS
  The incidence of unprovoked seizures was between 30 and 204/100,000 person years (n=766) in the different age groups. It was highest among the youngest children and lowest among the 18-year-olds with small gender differences. The most common neurodevelopment comorbidities were developmental delay (22%, CI: 19-25%), speech/language and learning difficulties (23%, CI: 20-26%) and intellectual disability (16%, CI: 13-18%). The types of neurodevelopmental comorbidity varied by age at the time of seizure onset, with cerebral palsy being more common among the 0-5-year-olds, attention deficits among the 6-16-year-olds, and autism and psychiatric diagnosis among the older children. An associated neurodevelopmental comorbidity was more common among those experiencing recurrent than single seizures during follow-up six months from the index seizure (42% versus 66%). In 68% (CI: 64-71%) of the children there was no known or suspected neurodevelopmental comorbidity.
  
  
  CONCLUSIONS
  The incidence of unprovoked, non-febrile seizures among 0-18-year-olds included in the SIRE was 67/100,000 person-years. Neurodevelopmental comorbidities were common already at the time of onset of the seizure disorder, indicating that neither seizure treatment nor seizures were the underlying cause of other neurodevelopmental symptoms in these patients during the period studied.
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, 611 85 Nykoping, Sweden. Electronic address: evaandell@gmail.com.
authors.forename: Eva
authors.initials: E
authors.lastname: Åndell
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden.
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Tomson
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
authors.forename: Sofia
authors.initials: S
authors.lastname: Carlsson
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Hellebro
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Andersson
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Adelöw
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Åmark
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D002658:Developmental Disabilities / Q000145:classification / Q000453:epidemiology*; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D065886:Neurodevelopmental Disorders / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies
keywords: Children; Cohort; Epidemiology; Epilepsy; Neurodevelopmental comorbidity; Seizure