title: Long-term changes in the incidence of childhood epilepsy. A population study from Finland.
abstract: The incidence of childhood epilepsy has changed during the past decades, but it is unclear whether it increased or decreased.
  
  
  
  Changes in drug-treated childhood epilepsy between 1968 and 2012 were evaluated using the Finnish nationwide register of all children, aged ≤15years, on antiepileptic drugs (AEDs) prescribed for the treatment of epilepsy. The first registered entitlement to full-refundable AEDs was used as a proxy for newly diagnosed epilepsy. Incidence densities were calculated as ratios of annual new cases per 100,000person-years in each calendar year during 1968 to 2012.
  
  
  
  The annual incidence density of newly treated childhood epilepsy increased from 35 in the 1960s to 87 per 100,000person-years in the 1990s and decreased thereafter to 61 per 100,000person-years. Since 1996, the incidence density decreased 1-2% per year in children aged <1, 1-5, or 6-10years (all 95% confidence intervals within 0.3%-3%), while no substantial change was seen in older children.
  
  
  
  The incidence of drug-treated childhood epilepsy from the late 1960s to the early 1990s distinctly increased. The reasons for the increase are not fully understood but may include increasing ascertainment through improved diagnosis and a wider acceptance of AED treatment. Since the 1990s, a slight decline can be seen, probably reflecting the recent improvement in child health and safety.
authors.affiliation: Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland; Department of Child Neurology, University of Turku and Turku University Hospital, Turku, Finland; Doctoral Programme of Clinical Investigation, University of Turku, Turku, Finland. Electronic address: maiju.m.saarinen@utu.fi.
authors.forename: Maiju M
authors.initials: MM
authors.lastname: Saarinen
authors.affiliation: Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland; Department of Child Neurology, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Sillanpää
authors.affiliation: Epilepsy Research Group, Berlin, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Schmidt
authors.affiliation: Research Department, The Social Insurance Institution of Finland (KELA), Turku, Finland.
authors.forename: Lauri J
authors.initials: LJ
authors.lastname: Virta
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011159:Population Surveillance / Q000379:methods; D012042:Registries; D013997:Time Factors
chemical_list: D000927:Anticonvulsants
keywords: Annual incidence density; Childhood epilepsy; Nationwide registers; Population epidemiology; Secular trends