Objective: To analyze the epidemiological characteristics and proportional distribution of epilepsy and epileptic syndromes among primary school children.
Patients and methods: The medical records of all children diagnosed with epilepsy between the ages of 6 and 12 years who attended a follow-up visit in 2005 were retrospectively reviewed. The sample consisted of 169 patients (85 boys and 84 girls). Epidemiological and clinical characteristics and complementary investigations were collected. The criteria defined by the International League Against Epilepsy (ILAE) were used in the diagnosis.
Results: The mean age at diagnosis was 8.8 years (95% CI: 0.2). The mean duration of follow-up was 3.5 years (95% CI: 0.32). Etiology was idiopathic in 102 patients (60.4%), cryptogenic in 36 (21.3%), and symptomatic in 31 (18.3%). A personal and/or familial history of febrile seizures was reported in 10.7% and familial epilepsy was found in 23.5%. Neuroimaging was performed in 162 patients (95.9%), and anomalies were detected in 33 (20.4%). In idiopathic epilepsies, generalized epilepsies were observed in 56.9% of the patients and focal seizure in 43.1%. Focal seizures were more frequent than generalized epilepsy in cryptogenic (63.9% versus 27.8%) and symptomatic forms (74.2 % versus 22.6%). The most prevalent syndromes were benign focal seizures (26.1%) and typical absence seizures (20.7%). Children with symptomatic epilepsies had a greater prevalence (p<0.05) of learning difficulties (66.7%) than those with cryptogenic (32.4%) or idiopathic forms (2.9%).
Conclusions: Most seizures in primary school children were idiopathic (benign focal seizures and/or typical absence seizures) and did not interfere with schooling. Cryptogenic and symptomatic epilepsies were less prevalent, but a high proportion of patients had substantial neurological and mental impairment or was refractory to antiepileptic drugs, giving rise to educational and psychological needs requiring specialized intervention.