The Prevalence of Epilepsy and Seizures in Subjects with Fetal Alcohol Spectrum Disorders
FASD , Epilepsy
The Prevalence of Epilepsy and Seizures in Subjects with Fetal Alcohol Spectrum Disorders. MSc Thesis, Queen’s University, Kingston, Ontario, Canada, May 2009. OBJECTIVE: Fetal alcohol spectrum disorders (FASD) is the umbrella term that describes the range of adverse developmental outcomes that occur in offspring as a consequence of maternal drinking during pregnancy. FASD has been associated with a large number of co-morbidities, including neurological disorders such as epilepsy. Epilepsy occurs in 0.6% of the population in Canada. The aim of this study was to evaluate the prevalence of epilepsy or seizure disorders in people who have been diagnosed with Fetal Alcohol Syndrome (FAS), partial Fetal Alcohol Syndrome (pFAS) or Alcohol Related Neurodevelopmental Disorder (ARND). METHODS: A retrospective chart review was conducted on all active charts (N=1063) at St. Michael’s Hospital (Toronto) and Glenrose Rehabilitation Hospital (Edmonton) FASD clinics. A total of 425 subjects between the ages of 2 to 49 were included in the analysis. The relationship between FASD diagnosis and other risk factors for co-occurrence of epilepsy and seizures (e.g. extent of exposure to alcohol and other drugs, type of birth, maternal history, and trauma) in subjects with FASD was also examined. Chi-square tests and multivariate multinomial logistic regression were used. RESULTS: Twenty-five (5.9%) individuals with FASD had a confirmed diagnosis of epilepsy, and 50 (11.8%) had at least one documented seizure episode, yielding an overall prevalence of 17.7% with a history of seizures in this population. Those with epilepsy or seizures were two times (Odds Ratio=2.27, 95% Confidence Interval=1.14-4.51, p<0.05) more likely to have an unnatural birth and those with epilepsy were three times (OR=3.41, 95% CI 1.11-10.5, p<0.05) more likely to have had an unnatural type of birth (breech, caesarean, forceps or vacuum) than those subjects with no history of seizures. None of the other risk factors examined were associated with a greater prevalence of epilepsy or seizures in subjects with FASD. These results indicate a remarkably high prevalence of epilepsy/seizures in the FASD population of two specialized FASD clinics compared with the general population.