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Trial Lecture – time and place
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Adjudication committee
- First opponent: Professor Lieven Lagae, Katholieke Universiteit Leuven
- Second opponent: Chief Neurologist Noemi Becser Andersen, Rigshospitalet Copenhagen
- Third member and chair of the evaluation committee: Professor II Bjørnar Hassel, University of Oslo
Chair of the Defence
Professor Emeritus Leif Gjerstad, University of Oslo
Principal Supervisor
MD, PhD Kari Modalsli Aaberg, Oslo University Hospital
Summary
Childhood- and youth-onset epilepsy includes conditions with very different courses, from self-limited syndromes to developmental and/or epileptic encephalopathies (DEE) with substantial comorbidity. Contemporary, population-based estimates reflecting current diagnostics (MRI, genetics) and classification are needed to answer three practical questions: How often does epilepsy occur? How quickly do seizures come under control? Which children are likely to develop drug-resistant epilepsy (DRE)? Much of the existing evidence predates current classification and care pathways.
The aims of this thesis were to quantify the occurrence and clinical spectrum of childhood- and youth-onset epilepsy using the current International League Against Epilepsy (ILAE) framework for seizure types, epilepsy types, syndromes and aetiologies. It also aimed to determine seizure outcomes—12-month seizure freedom, time to seizure freedom, age-specific active epilepsy and drug-resistant epilepsy (DRE)—based on longitudinal medical-record data, and to evaluate prognostic factors, including age at onset, aetiology, syndrome and key clinical characteristics.
The study builds on the Norwegian Mother, Father and Child Cohort Study (MoBa), linked to national registries. Epilepsy diagnoses were validated through nationwide medical record review, enabling systematic classification and longitudinal assessment of outcomes.
With a cumulative incidence of approximately 1% by age 18, most children with epilepsy became seizure-free, while drug-resistant epilepsy was concentrated in early-onset epilepsies and in those with identified aetiologies, including DEE. Reporting complementary outcomes—seizure freedom at end of follow-up, time to seizure freedom, active epilepsy and DRE—provides a balanced basis for clinical dialogue, follow-up and health service planning.
Overall, this thesis delivers contemporary, ILAE-aligned, population-based evidence linking occurrence with outcomes in childhood and youth epilepsy.
Additional information
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