Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-19T04:30:32.768Z Has data issue: false hasContentIssue false

Prevalence and Associated Features of Epilepsy in Adults with Down's Syndrome

Published online by Cambridge University Press:  02 January 2018

R. W. McVicker*
Affiliation:
Muckamore Abbey Hospital, 1 Abbey Road, Muckamore, Antrim BT41 4SH
O. E. P. Shanks
Affiliation:
Muckamore Abbey Hospital, 1 Abbey Road, Muckamore, Antrim BT41 4SH
R. J. McClelland
Affiliation:
The Queen's University of Belfast, The Whitla Medical Building, 97 Lisburn Road, Belfast BT9 7BL
*
Correspondence

Abstract

The aim of this study was to establish the prevalence of epilepsy in persons with Down's syndrome aged 19 years and over. A total of 191 adults with Down's syndrome were identified, giving a prevalence of 0.76/1000 (95% CI 0.75 to 0.77). Of these, 18 had epilepsy, giving a prevalence of 9.4% (95% CI 5.3% to 13.5%). The prevalence of epilepsy increased with age, reaching 46% in those over 50. The neurophysiological (EEG) findings of the epilepsy group were compared with those of a control group of Down's syndrome adults without epilepsy. Paroxysmal abnormalities consistent with a diagnosis of epilepsy were found in 80% of the epilepsy group, compared with only 13% of controls (P < 0.001). Epilepsy of late onset was associated with diffuse EEG abnormalities and clinical evidence of dementia. The age distribution and EEG findings suggest two independent processes in the causation of epilepsy: late-onset epilepsy associated with clinical evidence of dementia, and early-onset epilepsy in the absence of dementia.

Type
Papers
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Carter, G. & Jancar, J. (1983) Mortality in the mentally handicapped: a 50 year survey at the Stoke Park Group of Hospitals (1930–1980). Journal of Mental Deficiency Research, 27, 143156.Google Scholar
Cork, L. C. (1990) Neuropathology of Down syndrome and Alzheimer's disease. American Journal of Medical Genetics (suppl. 7), 282286.Google Scholar
Evenhuis, H. M. (1990) The natural history of dementia in Down's syndrome. Archives of Neurology, 47, 263267.CrossRefGoogle ScholarPubMed
Fenton, G. W. (1986) The EEG, epilepsy and psychiatry. In What is Epilepsy? (eds Trimble, M. R. & Reynolds, E. H.), p. 139. Edinburgh: Churchill Livingstone.Google ScholarPubMed
Forsgren, L., Edvinsson, S. O., Blomquist, H. K., et al (1990) Epilepsy in a population of mentally retarded children and adults. Epilepsy Research, 6, 234248.Google Scholar
Hauser, W. A., Morris, M. L., Heston, L. L., et al (1986) Seizures and myoclonus in patients with Alzheimer's disease. Neurology, 36, 12261230.Google Scholar
International League Against Epilepsy: Commission on Classification and Terminology (1981) Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia, 22, 489501.CrossRefGoogle Scholar
Jervis, G. A. (1948) Early senile dementia in mongoloid idiocy. American Journal of Psychiatry, 105, 102106.CrossRefGoogle ScholarPubMed
Kirman, B. H. (1951) Epilepsy in mongolism. Archives of Disease in Childhood, 26, 501503.Google Scholar
Lai, F. & Williams, R. S. (1989) A prospective study of Alzheimer's disease in Down's syndrome. Archives of Neurology, 46, 849853.Google Scholar
Langdon Down, H. J. (1866) Observations on an ethnic classification of idiots. Clinical Lectures and Reports, London Hospital, 3, 259262.Google Scholar
MacGillivray, R. C. (1967) Epilepsy in Down's anomaly. Journal of Mental Deficiency Research, 11, 4348.Google Scholar
Mallon, J. R., MacKay, D. N., McDonald, G., et al (1991) The prevalence of severe mental handicap in Northern Ireland, Journal of Mental Deficiency Research, 35, 6672.Google Scholar
Mattson, R. H., Cramer, J. A., Collins, J. F., et al (1992) A comparison of valproate with carbamazepine for the treatment of complex partial seizures and secondarily generalised tonic–clonic seizures in adults. New England Journal of Medicine, 327, 765771.Google Scholar
Miniszek, N. A. (1983) Development of Alzheimer disease in Down syndrome individuals. American Journal of Mental Deficiency, 87, 377385.Google Scholar
Oliver, C. & Holland, A. J. (1986) Down's syndrome and Alzheimer's disease: a review. Psychological Medicine, 16, 307322.Google Scholar
Olson, M. I. & Shaw, C. M. (1969) Presenile dementia and Alzheimer's disease in mongols. Brain, 92, 147156.CrossRefGoogle Scholar
Pueschel, S. M., Louis, S. & McKnight, P. (1991) Seizure disorders in Down syndrome. Archives of Neurology, 48, 318320.Google Scholar
Romano, C., Tine, A., Fazio, G., et al (1990) Seizures in patients with trisomy 21. American Journal of Medical Genetics, (suppl. 7), 298300.Google Scholar
Schweber, M. S. (1989) Alzheimer's disease and Down syndrome. Progress in Clinical and Biological Research, 317, 247267.Google Scholar
Slater, E. & Roth, M. (1969) Mental subnormality. In Clinical Psychiatry, p. 722. London: Bailliere, Tindall & Cassell.Google Scholar
Tangye, S. R. (1979) The EEG and incidence of epilepsy in Down's syndrome. Journal of Mental Deficiency Research, 23, 1724.Google ScholarPubMed
Veall, R. M. (1974) The prevalence of epilepsy among mongols related to age. Journal of Mental Deficiency Research, 18, 99106.Google Scholar
Wisniewski, K. D., Dalton, A. J., Crapper, D. R., et al (1985) Alzheimer's disease in Down's syndrome: clinicopathological studies. Neurology, 35, 957961.Google Scholar
Zigman, W. B., Schupf, N., Lubin, R. A., et al (1987) Premature regression of adults with Down's syndrome. American Journal of Mental Deficiency, 92, 161168.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.