FV 1119. Incidence of Epilepsies and Epileptic Syndromes in Children and Adolescents: A Prospective Study in Göttingen, Germany in 2014

Background: Epilepsy is considered rather a multietiological symptom than a disease and constitutes the most common neurologic condition in childhood and adolescence. The incidence rate (i.e., the number of new cases per population during a given time period) of epilepsies depends on genetic and environmental factors as well as on accuracy of diagnosis and on operative definition what shall be termed “epilepsy.” In Germany, three retrospective studies on incidence of epilepsy in children and adolescents were performed, all of them more than 25 years ago. A single incidence study with prospective design was performed in 1999/2000.

Objective: This study aimed at determining the incidence of epilepsies and epileptic syndromes in children and adolescents younger than 16 years of age in a medium-sized German city in a population-based setting and resting upon the new diagnostic criteria of the International League Against Epilepsy.

Methods: Based on the notes in the EEG laboratory journal of the Children’s Hospital, University Medical Center Göttingen, Germany, we compiled data of all those patients who underwent an EEG for evaluation of a first seizure or a newly diagnosed epilepsy during the period between January 1, 2014, and December 31, 2014. Incidence was calculated based on the population figures of the closest catchment area of our hospital including the city of Göttingen, the county of Göttingen, and the county of Northeim.

Results: In 2014, a total of 2,481 EEGs were recorded in the EEG laboratory of the Children’s Hospital, University Medical Center Göttingen. Thereof, 134 were requested for evaluation of a first seizure (43 occasional seizures) or a newly diagnosed epilepsy (n = 91), as revealed by assessment of EEG findings and clinical data. One additional patient was reported by a neurologist from his private practice in Göttingen. Thus, 135 patients were included in this study. Based on the population figures of the city of Göttingen, the county of Göttingen, and the county of Northeim, we calculated an incidence of epilepsies in children and adolescents (< 16 years of age) of 97.8 per 100,000 inhabitants (in this age range), approximately of 1:1,000. Focal epilepsies as a whole (symptomatic and cryptogenic focal epilepsies [n = 35; 38%] as well as benign genetic partial epilepsies [n = 22; 24%]) were more frequent (n = 62; 67%) than generalized epilepsies (n = 20; 22%).

Relating to all epilepsies taken together, the benign genetic partial epilepsies were the second most common subgroup. Among these benign focal epilepsies, there were 12 cases (55%) of benign epilepsy with centrotemporal spikes (Rolandic epilepsy), whereas 7 patients (32%) had Panayiotopoulos’ syndrome.

We found a peak of incidence (19%) in the first year of life. Children with generalized epilepsies had a mean age of 8.8 years at diagnosis, whereas patients with focal epilepsies were clearly younger (mean age 5.4 years). There was even distribution between the sexes.

Conclusion: Previous German studies showed somewhat lower incidences of ca. 52 to 72/100,000. Our findings indicate that the new definition of epilepsies proposed by the ILAE has consequences for incidences of epilepsies. In addition, methodological, regional, ethnic, and social factors play a role for epilepsy incidence.