Epilepsy in children: prevalence, disability, and handicap.

Little is known about the handicapping effect of epilepsy without other neurological deficits on an epileptic individual's life. The purpose of this study was to collect information on the occurrence of disabilities and handicaps in an unselected population sample of children, 4-15 years of age, and to compare the results with matched controls. The prevalence of epilepsy in the study population was 0.68% (143/21, 104). Time elapsed from last seizure was at least 1 year in 62.1% of the cases. There was marked neurologic comorbidity in the children with epilepsy; an accessory neurological deficit was found in 39.9%, the most frequent neurological impairments being mental retardation (31.4%), speech disorders (27.5%), and specific learning disorders (23.1%). A handicap was experienced in 20.7% of children with epilepsy only; i.e., with no other neurologic impairments, compared to 0.9% of matched controls. This means a 21.7-fold (95% CI, 6.3-74.5) risk of the occurrence of a handicap in children with epilepsy compared to controls. Orientation and social integration handicaps were significantly more frequent in children with epilepsy only compared to controls. Occurrence of communication disability, situational disability, or satisfactory to poor economic status of the family were the independent predictors of the occurrence of a handicap in children with epilepsy only.