Mortality, major neurological handicaps--including mental retardation, cerebral palsy and epilepsy--educational subnormality and height at 14 years of age were studied by birth weight percentiles in a birth cohort of 12 000 children from northern Finland. Infant mortality was significantly higher below the mean -2 SD, 10th and 25th percentiles, than in the median class, from 25th to 75th percentiles, but mortality from one to 14 years only in the lowest weight class. Educational subnormality, including mental retardation +/- some other handicap, was highly significantly more frequent in all the percentile classes lower than the median class but showed no significant tendency to be less frequent in the percentiles over the median. It was also highly significantly more frequent among the preterm than the term infant. The number of children with a major neurological handicap but normal school performance did not vary significantly by birth weight percentiles or by gestational age. Height at 14 years increased significantly by birth weight percentiles. The height of the boys with birth weight mean - and +2 SD was nevertheless within the 25th-75th percentiles for height at 14 years in general, while the height of the girls came close to these percentile limits. The preterm infants were significantly shorter than the term infants at 14 years.
Department of Cardiology, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: kristina.haugaa@rr-research.no.
The long QT syndrome (LQTS) is an inherited cardiac channelopathy associated with syncope and sudden cardiac death due to ventricular arrhythmias. It is most frequently caused by potassium channel mutations. Potassium channels are also expressed in brain tissue and play an important role in idiopathic epilepsies. Recent reports have indicated that related potassium channel mutations may coexpress as concomitant epilepsy and LQTS.
The purpose of this study was to explore cerebral activity by means of EEG recordings in individuals with LQTS related to potassium channel mutations.
Seventeen individuals with confirmed LQTS related to potassium channel mutations (11 LQT1 and 6 LQT2) were prospectively studied with 21-channel electroencephalography (EEG) LQTS -related symptoms, comorbidity, medication, and QTc (12-lead ECG) were recorded. Sixteen healthy individuals previously studied with EEG served as a control group. All EEGs were reviewed by two independent neurophysiologists.
EEG recordings were abnormal in 12 of 17 patients (71%) in the LQTS group, whereas abnormalities were present in only 2 of 16 healthy controls (13%; P
The paper presents some methodological problems concerning modeling of the processes of accumulation and prevalence of the pathological states caused by head injury in the population. The trend in the number of annual cases of new injuries of the head is estimated for at least 10 years for different age groups of the population. The average indices are estimated together with the limits of their fluctuations. Taking into consideration the mean expectation of life both the average annual quantity of the individuals with head injury in the anamnesis and probability of their accumulation are determined. This index equals to 22.22 per 1000. The frequency of the craniocerebral traumas was estimated in comparison with the total quantity of head injuries: 18.7 +/- 3.18% for children; 38.6 +/- 3.97% for the adults.
The aim of this study was to investigate birth rates and use of hormonal contraception in different age groups among women with epilepsy (WWE) in comparison to women without epilepsy.
Demographic data and medical information on more than 25,000 pregnant women (40,000 births), representing 95% of all pregnancies in Oppland County, Norway, were registered in the Oppland Perinatal Database in the period 1989-2011. Data were analyzed with respect to epilepsy diagnoses, and 176 women with a validated epilepsy diagnosis (303 pregnancies) were identified. Age-specific birth rates in these women were estimated and compared with age-specific birth rates in women without epilepsy in the same county.
In WWE over 25 years of age, birth rates were significantly lower than in those of the same age group without epilepsy. In women below 20 years of age, birth rates were similar in those with and without epilepsy. The use of hormonal contraceptives prior to pregnancy was lower among WWE under 25 years than in the corresponding age group without epilepsy.
Health professionals who counsel WWE who are of fertile age should be aware of the strongly reduced birth rates in WWE over 25 years of age, and the lower rates of use of contraceptives among young WWE.
Analysis of paediatric dental services provided at a regional hospital in Sweden. Dental treatment need in medically compromised children referred for dental consultation.
All inpatients at a regional hospital in Sweden referred for a paediatric dental consultation (n = 269) were studied retrospectively during a two-year period. The children were studied concerning their medical and oral condition and subsequent dental treatment. The most frequent medical condition among the referred children was insulin dependent diabetes mellitus (20%), asthma (9%) and epilepsy (7%). Children with asthma exhibited a significantly increased caries prevalence (p
The initial data for the analysis have resulted in epidemiologic (547 patients) and genetic-epidemiologic (365 patients) study of patients with diagnosis of epilepsy living in five districts of the Khabarovsk Territory. The population frequency of epilepsy was equal to 0.288%. With the use of data on numbers of sick and healthy first-third-degree relatives, and the method of maximum likelihood, the monolocus diallelic model (MDM) parameters of the family and population epilepsy prevalence were estimated. For each of 9 MDM variants two decisions were obtained, depending on the use of population probability of the feature. The analysis of 8 sets of initial data allowed to ascertain the influence of information about the first-third-degree relatives on parameter estimates. The calculation results are presented for one of initial data sets (set A). Three MDM variants were shown to predict the values of the relative affection probability, these being rather close to frequencies observed. The arguments are presented in favour of quasi-dominant variant with following parameters: frequency of mutant allele in a population - 5.28%, homozygote penetrance - 21.5% and that for heterozygote - 2.6%. According to parameter estimates within this model, the probability of offspring disease in the family with the known number of sick and healthy parents was calculated.
In an epidemiological study of a county cohort of 4,138 liveborn children, surveyed at age four, 45 had disability (1.1%). The following period prevalences from birth to age four in per mille were found: motor handicap 5.1, to include cerebral palsy 4.1, myelomeningocele and hydrocephalus 0.5, and metabolic disorders 0.5; severe mental retardation 2.9, mild 1.4, subnormality 2.7; epilepsy 4.6; severe visual defect 1.4; severe auditory defect 0.7. Perinatal damage alone was likely in only three children out of 45. Two thirds had a prenatal cause or a combination of prenatal and perinatal causes. Birth asphyxia seemed to be a rare cause of motor disability and mental retardation. Prematurity per se gave a risk of spastic diplegia, but not of mental retardation. Among the mentally retarded, half were light for gestational age, and in more than half, the damage occurred prenatally.
An epidemiological community-based study of incident cases with non-provoked epileptic seizures, using case-referent methodology, was carried out to explore possible risk factors for epileptic seizures. 83 cases, between 17 and 74 years of age, of whom 67.4% had seizures of localized onset, were compared with 2 age- and sex-matched referents. Higher birth weight, movement disabilities, mental retardation, head trauma, brain tumor, depression, a period of unemployment during the previous 6 months and a history of epilepsy in relatives were more common in cases than in referent subjects. No difference was found in the socioeconomic factors investigated, except that the cases belonged to smaller households. Prematurity, home or hospital birth, parents' age at birth of cases or referents, febrile convulsions in relatives, various infections including meningitis and encephalitis, cerebrovascular disease, and alcohol, tobacco, sleep and nutritional habits were not found to be associated with development of seizures. The recent life events investigated, at home or at work, occurred as often in cases as in referents, except that significantly fewer cases had received any increase in salary during the last 6 months. The relationship between depression and development of seizures should be explored further. Moreover, the possibility of false negative results should be considered because of the sample size.
Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. espen.lien@ntnu.no
The aim of this study was to examine whether the presence of the apolipoprotein E (ApoE) allele APOEe4 is associated with less severe manifestations of cerebral palsy (CP), consistent with the suggested beneficial effect of this allele on neurodevelopment in children.
ApoE genotyping was performed on buccal epithelial cells from 255 children (141 males 114 females; mean age 12y, SD 2y 3mo, range 9-17y) recorded in the Cerebral Palsy Register of Norway. The main outcome measure of CP severity was the Gross Motor Function Classification System (GMFCS). Secondary outcome measures were fine motor function, epilepsy, and the need for gastrostomy tube feeding (GTF).
There was no association between the APOEe4 genotype and GMFCS levels (odds ratio [OR] 1.15; 95% confidence interval [CI] 0.66-1.99). However, the APOEe4 genotype was more often present among children with epilepsy (OR 2.2; 95% CI 1.1-4.2) and/or receiving GTF (OR 2.7; 95% CI 1.1-6.6). Among children with unilateral CP, the presence of APOEe4 was associated with more severe fine motor impairment (OR 2.6; 95% CI 1.3-6.9).
Our main hypothesis that APOEe4 would have a protective effect on neurodevelopment was not supported. Instead, subgroup analyses suggested an adverse effect of the APOEe4 genotype on the developing brain after injury.
