Prevalence of childhood epilepsy in Estonia

Purpose: To establish the prevalence rate (PR) and main characteristics of childhood epilepsy in Estonia. Methods: We performed a population-based case ascertainment of all the poss ible sources of medical care in seven counties of Estonia from January 1995 to December 1997. Only cases of patients from 1 month to 19 years of age w ith active epilepsy (i.e., at least one seizure during the last 5 years, re gardless of treatment) were included. Al patients were examined by a pediat ric neurologist. Results: Five hundred sixty cases met the study criteria on the prevalence day, December 31, 1997. The total PR was 3.6 per 1,000 population (boy/girl ratio, 1.2:1.0). The PR was the highest-4.3 per 1,000-in the 5-to-9-year-o ld age group. The prevalence declined markedly in children age 14 years and on. The correlation between age and PR was negative (-0.542, p < 0.0001) b y regression analyses. The most frequent seizure types in the total-group w ere primarily generalized seizures-PR 2.1/1,000 [rate ratio (RR) 1.4, 95% c onfidence interval (CI) 1.2. 1.6]. The predominance of generalized seizures was significant in those younger than 10 years. In 14.8% of cases, there w as a history of epilepsy among first- and second-degree relatives. Benign r olandic epilepsy-PR 0.2/1,000-was the most frequent among idiopathic syndro mes, and Lennox-Gastaut syndrome-PR 0.08/1,000-was the most frequent among cryptogenic ones. Perinatal factors-PR 0.8/1,000 were the most frequently f ound cause of epilepsy. in 304 cases (54.2%), additional medical problems e xisted. Conclusions: The prevalence of childhood epilepsy was comparable with that found in developed countries. Generalized seizures predominated, and the ma in cause was perinatal factors.