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The incidence of first provoked and unprovoked seizure in pediatric patients with and without psychiatric diagnoses.

McAfee AT, Chilcott KE, Johannes CB, Hornbuckle K, Hauser WA, Walker AM

i3 Drug Safety, Waltham, Massachusetts 02451, USA. andrew.mcafee@i3drugsafety.com

PURPOSE: To estimate the rate of new-onset afebrile provoked and unprovoked seizure in a general pediatric population and subgroups of patients with and without psychiatric diagnoses other than attention deficit hyperactivity disorder (ADHD). METHODS: A retrospective cohort study of 133,440 pediatric patients, between the ages of 6 and 17 years, and without history of seizure or prior use of anticonvulsant medications, with follow-up during 2003. The data source for this study was Ingenix's research database containing pharmacy and medical claims for members of a large US-based managed care organization. The main outcome measure was new-onset nonfebrile seizure. Incidence rates of seizure and 95% confidence intervals (CI) were calculated and expressed as rates per 100,000 person-years. RESULTS: There were 132 new-onset provoked and unprovoked seizures in 78,423 person-years of follow-up among the general pediatric population sample. The incidence rate of seizure among the general pediatric population was 168 per 100,000 p-y (95% CI 141-200). The incidence rate of seizure among patients without psychiatric diagnoses was 149 per 100,000 p-y (95% CI 122-180). The incidence rate of seizure among patients with psychiatric diagnoses other than ADHD was 513 per 100,000 p-y (95% CI 273-878). There were increases in the incidence rates of seizure in all of the seizure risk factor groups, but this was more pronounced among males ages 6-12 with psychiatric diagnoses. CONCLUSIONS: The results of this study are consistent with previous reports showing that pediatric patients with psychiatric disorders have a higher incidence rate of seizure than the general pediatric population.

Published 7 June 2007 in Epilepsia, 48(6): 1075-82.
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