Type 1 Diabetes and Epilepsy in Children: Is There a Pathogenetic Association between Frequency, Manifestation, and Antibodies?

Background: Former studies have assumed a connection between type 1 diabetes and epilepsy in children and adolescents. In this study, clinical and antibody data of University Children Hospital Kiel are analyzed in detail.

Methods: A retrospective chart review was performed in the Pediatric Departments of the University Hospital in Kiel, Germany, in 321 patients with diabetes mellitus type 1, age younger than 18 years. In this diabetes cohort, all patients were identified and studied who had the additional diagnosis epilepsy. Results were compared with the literature.

Results: The pediatric department listed 321 patients diagnosed with type 1 diabetes, 17 of them with epilepsy, giving a prevalence of 53/1,000. This prevalence was ten times higher than the prevalence of epilepsy in the general population. In general, the type 1 diabetes had an earlier onset than the epilepsy and the patients were younger at the onset of diabetes compared with the patients with only diabetes. No higher level of diabetes-specific antibodies could be found in the study population of the University Hospital Kiel. No significant frequency could be demonstrated in age of the parents, pregnancy, birth, development in infancy, family surrounding, or medical treatment of the patients.

Conclusion: In children and adolescents with type 1 diabetes, epilepsy occurs strikingly more frequently compared with epilepsy alone in the general population. The question remains whether this demonstrates an association or a statistically significant common pathogenetic (autoimmunological?) background of the diseases in this cohort. Further studies should aim to enlarge sample sizes and add other parameter, for instance laboratory items as CNS autoantibodies.