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Temporal trends in incidence of Rolandic epilepsy, prevalence of comorbidities and prescribing trends: birth cohort study
  1. Jacqueline Stephen1,
  2. Christopher J Weir1,2,
  3. Richard FM Chin2,3
  1. 1 Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK
  2. 2 Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences and MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
  3. 3 Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK
  1. Correspondence to Dr Richard FM Chin, Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences and MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh EH8 9YL, UK; r.chin{at}ed.ac.uk

Abstract

Objective To examine temporal trends in incidence of Rolandic epilepsy (RE), prevalence of comorbidities and antiepileptic drug (AED) prescribing patterns.

Design Retrospective cohort study.

Setting The UK.

Patients Children aged 0–16 years born 1994–2012 were followed from birth until September 2017, transfer to another general practitioner practice or death or practice withdrawal from The Health Improvement Network (THIN), whichever occurred first.

Main outcome measures Incidence of RE, prevalence of comorbidity and AED prescribing patterns. Read codes for comorbidities and AEDs were adapted from other UK population-based epilepsy studies.

Results There were 379 children with first RE event recorded between 2000 and 2014 from active THIN practices with available mid-year population counts. Crude annual incidence across all years was 5.31/100 000 (95% CI 4.81 to 5.88). There was no significant time trend in adjusted incidence rate ratios (aIRR) (0.99/year, 95% CI 0.96 to 1.02). Males had higher aIRR (1.48, 95% CI 1.20 to 1.82) as did children aged 6–8 and 9–11 years compared with 4–5 years (aIRR 2.43, 95% CI 1.73 to 3.40; aIRR 2.77, 95% CI 1.97 to 3.90, respectively). There was recorded comorbidity in 12% with 6% with a recorded diagnosis of pervasive developmental disorder. Half of children with RE had a record of being prescribed AEDs.

Conclusions UK incidence of RE has remained stable with crude incidence of 5/100 000/year. Carers and clinicians need to be aware that comorbidities may exist, particularly pervasive developmental disorders. Carbamazepine is consistently the most commonly prescribed AED for RE in the UK.

  • epidemiology
  • general paediatrics
  • neurology
  • neurodevelopment
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/archdischild-2019-318212

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    Footnotes

    • Contributors RFMC conceptualised the study. All authors designed the study. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

    • Funding The study was funded by the Waterloo Foundation. CJW was supported in this work by NHS Lothian via the Edinburgh Clinical Trials Unit.

    • Disclaimer The funders had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report and in the decision to submit the article for publication.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Epidemiological research using THIN data has ethical approval from the South East Multi-Centre Research Ethics Committee (Protocol Number 03/01/073). Additional study-specific approval was obtained from the THIN scientific review committee. Since additional information was not being sought from patients or carers, neither Multi-Centre Research Ethics Committee nor local Research and Development approval were needed.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data may be obtained from a third party.