DOI: https://doi.org/10.22141/2224-0713.6.108.2019.180529

Comorbid disorders and their characteristics in children with epilepsy manifestation

L.V. Shalkevich, I.V. Zhаuniaronak

Abstract


Background. The definition of epilepsy and its complications includes comorbidity. However, many questions about comorbid disorders in children with epilepsy at the time of onset of disease and prior to antiepileptic therapy remain unsolved. The purpose was to establish the frequency and identify comorbid disorders in children of different age groups at the stage of disease manifestation prior to the start of antiepileptic therapy. Materials and ­methods. Children from birth to 17 years old after the first unprovoked seizure (n = 556) were examined and included in a prospective study. Two groups were formed: 109 children with a single seizure and 447 patients with epilepsy. The frequency of comorbid disorders at the time of the first seizure was analyzed, as well as in age groups taking into account the age at the manifestation of epilepsy: up to 1 year, 1–3, 4–5, 6–13, 14–17 years. Results. The frequency of comorbid disorders in the onset of epilepsy is significantly higher than in single seizure: 68.0 and 13.8 %, respectively, pFisher < 0.001. The presence of comorbid pathology at the first seizure increases the risk of developing epilepsy by 13 times (odds ratio = 13.322; 95% confidence interval [7.459; 23.795]). A high comorbidity was detected in children under the age of 1 year — 80.8 %. Almost every third child has mental disorders at the onset of epilepsy (30.6 %) compared to a group of single seizure (0.9 %), pFisher < 0.001. In the group of up to 1 year (n = 193), already at the first epileptic seizure, more than half of the children had mental and speech/pre­verbal developmental delay — 53.4 %. Conclusions. A high frequency of comorbid disorders was detected in children with epilepsy in the onset of disease before the initiation of antiepileptic therapy (68.0 %). The highest frequency of mental comorbidity in the onset of epilepsy before the start of therapy was observed in children under 1 year of age (50.8 %), which is almost 10 times higher than in the onset of epilepsy in older children.


Keywords


comorbid disorders; epilepsy; children

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