Abstracts

A genetic influence is evident in many forms of epilepsy. The magnitude of this influence may vary in relation to epilepsy classification and localization. We assessed this genetic influence in a large epilepsy patient population, by examining family history of epilepsy and febrile seizures, particularly in first degree relatives.
Patients were evaluated in the epilepsy clinic of the first author and had well-documented epilepsy. Family history of epilepsy and febrile seizures in first and second degree relatives as well as first cousins was obtained from each patient, where available. Epilepsy classification was based on detailed clinical seizure description, routine EEG, EEG-video monitoring, and structural MRI. PET and ictal SPECT were performed in select patients. History of prior febrile seizures and other risk factors for epilepsy was obtained in all patients. A computerized database was used for data storage and data analysis. Chi Square Test was used for statistical analysis.
Among 1464 patients with epilepsy, 577 (39.4%) had a family history of epilepsy or febrile seizures, and 278 (19%) had a first degree relative with epilepsy or febrile seizures. Patients with antecedent febrile seizures (226) were significantly more likely to have first degree relatives with febrile seizures (p[lt].000001), but not first degree relatives with epilepsy (p=0.16). Patients with generalized epilepsy were only slightly more likely to have first degree relatives with epilepsy or febrile seizures than those with partial epilepsy (23.9% vs 18.4%, p=0.08). Patients with temporal and frontal lobe epilepsy were more likely to have first degree relatives with epilepsy than those with parietal and occipital lobe epilepsy (p[lt]0.05).
Based on the percentage of patients with first degree relatives with epilepsy or febrile seizures, a genetic influence is seen almost equally in partial and generalized epilepsy. Susceptibility for febrile seizures with subsequent epilepsy appears to be genetically distinct from susceptibility for afebrile seizures alone. Among patients with partial epilepsy, a genetic influence appears more likely with temporal and frontal seizure foci.