Autumn Meeting , Edinburgh , 6 and 7 October 1972

Familial factors and perinatal problems in idiopathic childhood epilepsy. D. H. Mellor, I. Lowit, and D. J. Hall introduced by G. Russell. Department of Child Health, University of Aberdeen. As part of a study of childhood epilepsy, 128 schoolchildren were identified who had been diagnosed as having epilepsy but who had no evidence of cerebral malformation, postneonatal brain damage, or abnormality on neurological examination. A history of epilepsy in a near relative was obtained in 40 of these children (familial subgroup) and was absent in the remaining 88 (nonfamilial subgroup). A control matched for age, sex, and school class was available for each study child. Prospectively recorded perinatal data were obtained for both study and control children. The incidence of 6 prenatal, 3 natal, and 6 neonatal factors known to be associated with a high risk of perimortality was determined in each subgroup. On analysis it was found that there was a significantly greater incidence of adverse perinatal factors in the nonfamilial subgroup as compared to its control group and to the familial subgroup. On the other hand, there was no significant difference between the familial subgroup and its control group or between the two control groups. These findings in the nonfamilial subgroup would lend support to the theory of a continuum of reproductive casualty in which conditions known to be associated with perinatal mortality are also associated with neurological dysfunction in survivors. The results also have implications for the prevention of epilepsy in this nonfamilial subgroup. However, the lack of association in the familial subgroup suggests that greater avoidance of adverse perinatal events may not prevent the appearance of epilepsy in such children.