UNPROVOKED SEIZURES AND DEVELOPMENTAL-DISABILITIES - CLINICAL CHARACTERISTICS OF CHILDREN REFERRED TO A CHILD-DEVELOPMENT CENTER

Few data are available on the risk of seizures in young children with developmental problems. A retrospective evaluation of 1,946 children 0 -5 years of age referred to the Tel Aviv Child Development Center (CDC ) between 1981 and 1990 was performed. The study was undertaken to det ermine the cumulative risk of unprovoked seizures in children referred to a CDC and to assess the risk factors associated with seizures in t hese children. The center serves the Tel Aviv area for a variety of de velopmental disabilities. Cumulative risk of seizures and risk factors were assessed using Kaplan-Meier methodology. Unprovoked seizures occ urred in 58 patients (3%), including 10 with a single seizure and 48 w ith two or more seizures. Risk factors for seizures included cerebral palsy (CP) (relative risk [RR] = 28.7), neonatal seizures (RR = 15.2), mental retardation (MR) (RR = 7.8), febrile seizures (RR = 7.7), auti sm (RR = 3.2), and prematurity (RR = 2.7). The cumulative risk of seiz ures by age 5 years in children with MR, CP, and MR plus CP was 8%, 47 %, and 68%, respectively, compared with 1% in those without MR or CP. On multivariate analysis, CP, MR, prior febrile seizures, and prematur ity were associated with an increased risk of seizures. The risk of ex periencing unprovoked seizures by age 5 in children with developmental disabilities is 3%, which is fourfold greater than that of the genera l population. Much of this increased risk is limited to selected subgr oups with major disabilities. However, if neither MR nor CP is present , the 1% risk of developing unprovoked seizures by age 5 in children w ith other developmental problems is not substantially different from t hat expected in the general population.