Clinical Factors and Comorbidities Associated With Uncontrolled Seizures in Children With Epilepsy: A Nationwide Study.

BACKGROUND

Childhood epilepsy is a common disease and has large impact on children and their families. Children with epilepsy are more likely to have comorbid diseases compared to general child population. However, there is limited evidence if comorbid diseases in children with epilepsy are associated with seizure control. This study aimed to evaluate if any comorbid diseases in children with epilepsy associated with seizure control by a national database.

METHODS

This study was a national survey of children with an age of less than 18 years of age who were currently treated at 12 hospitals in Thailand. Clinical factors including comorbid diseases were recorded. Factors associated with seizure uncontrolled were executed by using logistic regression analysis.

RESULTS

There were 4,558 children with epilepsy enrolled in the national survey. Of those, 1,263 children (27.71%) were defined as uncontrolled seizure. There were five significant factors in the predictive model for seizure uncontrolled: age at onset of epilepsy, duration of epilepsy, seizure type, comorbid diseases, and imaging lesions. The presence of comorbid disease had adjusted odds ratio of 1.80 (95% confidence interval of 1.43, 2.28). Among 11 neurological comorbid diseases, cerebral palsy and motor deficit had significant adjusted odds ratio of 2.16 and 1.99. Four developmental comorbid diseases had significant adjusted odds ratio: developmental problems, learning ability, autism, and intellectual disability/mental retardation. These four factors had adjusted odds ratios of 2.05, 1.27, 1.56, and 1.49, respectively.

CONCLUSIONS

Five significant clinical factors associated with seizure uncontrolled in children with epilepsy nationwide including age at onset of epilepsy, duration of epilepsy, seizure type, comorbid diseases, and imaging lesions. Six neurodevelopmental comorbid diseases were also significant factors associated with seizure uncontrolled in this setting.