Season of birth: aetiological implications for epilepsy

Abstract

In most cases of epilepsy it is not possible to reach an aetiological diagnosis. Recent research points to a pre-perinatal disruption of the neurodevelopment as being the cause of at least some of these epilepsies of unknown aetiology. The object of this study was to corroborate this hypothesis from an epidemiological perspective and identify the most likely candidates for causes of this damage. The approach used was an analysis of the seasonal pattern of births in a large sample of epileptic patients discharged from NHS hospitals in England and Wales. The results illustrated that the seasonality of the births in the epileptic sample was significantly different from that of the general population, with an excess of patients born in December and January and a deficit of those born in September. This "seasonality' was present only in the patients born before the late 1950s. These results are suggestive of the existence of an aetiological factor for epilepsy with a seasonal presence in the environment and which is epileptogenic when acting in the pre-perinatal period. Prenatal infections, obstetric complications and nutrititional deficiencies are amongst the hypotheses developed on the nature of this agent(s).