Epidemiology and long-term Turku outcome of childhood-onset epilepsy and mortality. Personal experiences. Part I

Prof. Dr. Matti Sillanpää, MD, PhD Department of Public Health 20014 University of Turku, Turku, Finland Phone: 358 400 829 428 Fax: 358 2 333 8439 e-mail: matti.sillanpaa@utu.fi Summary Introduction. Epidemiological studies on epilepsy were long based, with few exceptions, on hospital and institution patients with a subsequent bias toward more difficult cases and the reported prevalence and incidence rates were often obviously too low. Few data are available on the temporal changes in the incidence of epilepsy. Aim. To study the prevalence and incidence in an unselected child population including all the children living either in the society or in the institution, temporal changes in the incidence and mortality through five decades. Methods. The most important personal data were reviewed and compared with the relevant data of other investigators. Results and discussion. The prevalence of epilepsy in our study was 3.2/1000, quite obviously true for the contemporary methodology and well comparable with 3.4–4.2/1000 of other relevant studies published about two decades later and using a more advanced methodology. Similarly, the incidence of 35/100 000, ascertained in two Finnish studies, was comparable with the relevant contemporary literature data. Another study of ours shows that, probably associated with the people “coming from the shadows” and an improved diagnostic methodology, the incidence of childhood epilepsy has increased and is now 60–70/100 000. However, the incidence of childhood epilepsy shows an obvious decreasing trend in the first two decades of the 2000s. Conclusions. The incidence of childhood epilepsy, in all probability true for the contemporary methodology, was lower than it is now, but it now again shows a decreasing trend.