Abstracts

Studies of epilepsy have shown a significant burden of illness on those affected. There are limited studies examining the impact of epilepsy on children. Health care administrative databases provide a unique approach to describe epilepsy in children. A 1995 birth cohort was assembled in the province of Manitoba, Canada, from health care database records for a complete population in the setting of universal health care insurance. Children with epilepsy, as defined by the presence of an ICD-9 diagnosis code (345, 780, 779) from a hospitalization or physician visit, or a prescription of an anti-epileptic medication (AED) followed by a subsequent AED within a twelve month period, were identified over a 7 year period. A descriptive analysis was completed, examining the sociodemographics and health care utilization of this population. The rate of epilepsy was 6.25/1000 children. The overall age specific incidence of epilepsy was 57.5/100,000 children between birth and 7 years of age. The mean age of onset of epilepsy was 2.74 years (SD 1.89) with the majority being male. Total hospitalizations accounted for 0.58 hospitalizations per epilepsy person years, with a total of all physician visits equal to 12.7 visits per person years. A total of 1% of all physician visits were to a neurologist. Thirteen percent of children in the cohort saw a physician on a regular basis, defined by at least 70% of all visits to one physician. The AEDs most commonly prescribed included: phenobarbital (35.3%), carbamazepine (25.6%) and valproic acid (18%). A total of 37% of children were on continuous AEDs. Twenty four percent of children switched at least once to another AED, of these 72% only switched once. This is the first Canadian study to use population-based health care database records to describe the burden of illness of childhood epilepsy in the early years and patterns of health care utilization in the province. The prevalence of childhood epilepsy within Manitoba was similar to previous epidemiology studies in the literature. We observed that the majority of children with epilepsy received first-generation AEDs, which were mainly prescribed by family physicians. A low proportion of children had regular contact with one physician or used AEDs continuously. (Supported by a grant from the Manitoba Medical Services Foundation.)