Adverse Childhood Experiences Are Associated with Seizures in Children: A Cross-Sectional Analysis
Marissa Anto1, Shannon Shipley2, Shavonne Massey1, Christina Szperka1
1Neurology, The Children's Hospital of Philadelphia, 2The Children's Hospital of Philadelphia
Objective:
To assess the relationship between adverse childhood experiences (ACE/ACEs) and epilepsy.
Background:
The associations between exposure to ACE and a variety of neurological disorders, such as headache and ADHD, have been previously described in children. Few studies have investigated the association between ACEs and epilepsy. We aim to (1) assess the relationship between ACEs and epilepsy and (2) determine if there are specific ACEs that are more strongly associated with the diagnosis of epilepsy or seizure disorder in a pediatric cohort.
Design/Methods:
We performed a cross-sectional retrospective cohort analysis using population-based data from the 2018 and 2019 National Survey of Children’s Health to examine ACE and their relationship to epilepsy in children. ACEs elicited in the survey included questions about experience of violence, household dysfunction, and food and housing insecurity. Adjusting for age, race, and income level, we utilized logistic regression to test the relationships between cumulative ACE score and current seizure disorder or epilepsy diagnosis, and to examine which specific ACEs were individually associated with current seizure disorder or epilepsy diagnosis.
Results:
The study population consisted of 59,963 participants; 52.2% female and 47.8% male. Participant ages ranged from 0 to 17 years, and 69.2% identified as White. A current diagnosis of epilepsy or seizure disorder was reported in 377 participants (0.63%), and 22,749 participants (37.9%) had one or more ACE. As the number of ACEs increased, odds of current epilepsy or seizure disorder diagnosis increased by 1.14 (95% confidence interval 1.07-1.22). Five ACE exposures demonstrated a high association with a current diagnosis of epilepsy or seizure disorder: food/housing insecurity, witnessing domestic violence, household mental illness, neighborhood violence, and parent/guardian incarceration.
Conclusions:
Multiple ACE exposures were individually associated with reporting a diagnosis of epilepsy or seizure disorder. An increase in cumulative ACE exposures increased odds of having current diagnosis of epilepsy or seizure disorder.