Epilepsy in young children: A study based on the Norwegian Mother and Child Cohort (MoBa)

Most cases of childhood epilepsy debuts before five years of age. This is particularly the case for the more serious types of epilepsy. Despite this fact there is a lack of knowledge about prevalence, risk factors and clinical development of epilepsy in children. Most previous studies are performed in a specialist setting where participants more seriously affected are overrepresented. The prevalence of cognitive and behavioural problems in children with epilepsy is poorly documented, and it is currently unknown whether such problems are caused by epileptic activity. This lack of knowledge reduces the quality of interventions for children with epilepsy, especially with regard to needs that are not directly related to the epileptic seizures. This Project is based on the Norwegian mother and child cohort study (MoBa). MoBa is a population based cohort that includes 114 500 children and their parents. The overall goal is to identify and clincally characterize children with epilepsy within the MoBa cohort,and subsequently use clinical data and questionnaire data and biological material from MoBa to study causes of epilepsy.

Most cases of childhood epilepsy present before age five, particularly the most severe forms of epilepsy. Despite this, there is a substantial lack of knowledge about the prevalence, risk factors and natural history of early onset epilepsy (onset before a ge five). There is also limited knowledge about associated cognitive and behavioural impairments. Previous studies on early onset epilepsy have been based on hospital samples or populations of severely affected cases, not on general population samples, an d generally do not include longitudinal follow-up. This proposal seeks to remedy this situation by using longitudinal data from a large population-based child cohort to study the epidemiology of early onset epilepsy, applying a case-cohort design. We wi ll collect information on clinical characteristics and neurodevelopmental profiles, and copies of MRI scans and EEGs. Cluster analysis will be applied to this information as an innovative way of identifying various subtypes of epilepsy and investigating e arly life risk factors for the different subtypes. The project will be a collaboration between experts in epidemiology at the Norwegian Institute of Public Health (NIPH) and experts in childhood epilepsy at University College London (UCL) and University of Edinburgh (UoE). The cohort to be used is the Norwegian Mother and Child Cohort (MoBa), which was initiated by NIPH in 1999 1. MoBa includes 108,000 children and their parents. Identification of epilepsy cases in MoBa is ongoing, through questionnaire s and regular linkages to the Norwegian Patient Registry (NPR). We have already identified 596 MoBa participants with epilepsy diagnoses, and expect to find a total of 650 children with early onset epilepsy by the end of the study period. The data from this study will also be a valuable resource for future studies of childhood epilepsy, including genetic studies, and enable us to participate in international consortia for studies of childhood epilepsy.