Prevalence of Central Nervous System Diseases – A Large Retrospective Cohort Study of Adolescents

Abstract

At age sixteen, most Israeli nationals must undergo medical evaluation for compulsory military duty. All potential conscripts are referred to the Israel Defense Forces (IDF) recruiting office. Therefore, medical screening of a vast number of adolescents is performed, offering a unique opportunity to study the prevalence of neurological diseases in an entire age cohort. Hence, screening is not affected by diagnostic or methodological bias. We performed a retrospective neuroepidemiological large cohort study of adolescents from the database of the Israel Defense Forces recruiting office during the years 1998–2002. The survey included 409 492 adolescents, among them 162 079 (39.5%) females. The most prevalent diagnoses were: headache (754 per 10 000 adolescents), permanent brain damage (197 per 10 000), epilepsy (167 per 10 000) and movement and coordination disorders (36 per 10 000). These were followed by cranial nerve disorders, sleep disorders, cranio-spinal bone defects, and chronic progressive CNS disorders. The relative risk for male adolescents within the specific disease groups was higher for movement-coordination, sleep and cranial nerve disorders. Multivariate analysis revealed gender and severity prevalence and sex-grade, or year-grade interactions in the distinct groups of diseases. This study provides important information on the prevalence of neurological diseases in adolescents and demonstrates some significant epidemiological trends.

Key words

adolescents - nervous system - prevalence - epidemiology

References

• 1 Abdel-Khalek AM. Prevalence of reported insomnia and its consequences in a survey of 5 044 adolescents in Kuwait.  Sleep. 2004;  27 726-731
• 2 Bigal ME, Lipton RB, Winner P. et al . Migraine in adolescents. Association with socioeconomic status and family history.  Neurology. 2007;  69 16-25
• 3 Bloom B, Cohen RA. Summary health statistics for US children: National health interview survey, 2006.  Vital Health Stat 10. 2007;  234 1-79
• 4 Camarda R, Monastero R, Santangelo G. et al . Migraine headaches in adolescents: a five-year follow-up study.  Headache. 2002;  42 1000-1005
• 5 Dent W, Helbok R, Matuja WBP. et al . Prevalence of active epilepsy in a rural area in South Tanzania: a door-to-door survey.  Epilepsia. 2005;  46 1963-1969
• 6 Fendrich K, Vennemann M, Pfaffenrath V. et al . Headache prevalence among adolescents – the German DMKG headache study.  Cephalalgia. 2007;  27 347-354
• 7 Forsgren L, Beghi E, Oun A. et al . The epidemiology of epilepsy in Europe – a systematic review.  Eur J Neurol. 2005;  12 245-253
• 8 Freeman RD, Fast DK, Burd L. et al . An international perspective on Tourette syndrome: selected findings from 3500 individuals in 22 countries.  Dev Med Child Neurol. 200;  42 436-447
• 9 Gordon KE, Dooley JM, Wood EP. Self-reported headache frequency and features associated with frequent headaches in Canadian young adolescents.  Headache. 2004;  44 555-561
• 10 Hewer RL. The economic impact of neurological illness on the health and wealth of the nation and of individuals.  J Neurol Neurosurg Psych. 1997;  63 (S 01) 19-23
• 11 Johnson EO, Roth T. An epidemiologic study of sleep-disordered breathing symptoms among adolescents.  Sleep. 2006;  29 1135-1142
• 12 Johnson EO, Roth T, Schultz L. et al . Epidemiology of DSM-IV insomnia in adolescence: lifetime prevalence, chronicity, and an emergent gender difference.  Pediatrics. 2006;  117 e247-e256
• 13 Khalifa N, Von Knorring AL. Prevalence of tic disorders and Tourette syndrome in a Swedish school population.  Dev Med Child Neurol. 2003;  45 315-319
• 14 Koenig MA, Gladstein J, McCarter RJ. et al . Chronic daily headache in children and adolescents presenting to tertiary headache clinics.  Headache. 2002;  42 491-500
• 15 Kröner-Herwig B, Heinrich M, Morris L. Headache in German children and adolescents: a population-based epidemiological study.  Cephalagia. 2007;  27 519-527
• 16 Larsson B, Sund AM. One-year incidence, course, and outcome predictors of frequent headaches among early adolescents.  Headache. 2005;  45 684-691
• 17 Lazaratou H, Dikeos DG, Anagnostopoulos DC. et al . Sleep problems in adolescence. A study of senior high school students in Greece.  Eur Child Adolesc Psychiatry. 2005;  14 237-243
• 18 Linazasoro G, Ven Blercom N, Ortiz de Zárate C. Prevalence of tic disorders in two schools in the Basque country: results and methodological caveats.  Mov Dis. 2006;  21 2106-2109
• 19 MacDonald BK, Cockerell OC, Sander JW. et al . The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK.  Brain. 2000;  123 663-664
• 20 McMahon WM, Filloux FM, Ashworth JC. et al . Movement disorders in children and adolescents.  Neurol Clin N Am. 2002;  20 1101-1124
• 21 Menken M, Munsat TL, Toole JF. The global burden of disease study: implications for neurology.  Arch Neurol. 2000;  57 418-420
• 22 Millman RP. Working group on sleepiness in adolescents/young adults; and AAP Committee on adolescence. Excessive sleepiness in adolescents and young adults: causes, consequences, and treatment strategies.  Pediatrics. 2005;  115 1774-1786
• 23 Picchietti D, Allen RP, Walters AS. et al . Restless legs syndrome: prevalence and impact in children and adolescents – the Peds REST Study.  Pediatrics. 2007;  12 253-266
• 24 Rhee H. Prevalence and predictors of headaches in US adolescents.  Headache. 200;  40 528-538
• 25 Roberts RE, Roberts CR, Chan W. Ethnic differences in symptoms of insomnia among adolescents.  Sleep. 2006;  29 359-365
• 26 Stern JS, Burza S, Robertson MM. Gilles de la Tourette's syndrome and its impact in the UK.  Postgrad Med J. 2005;  81 12-19
• 27 Ünalp A, Dirik E, Kurul S. Prevalence and characteristics of recurrent headaches in Turkish adolescents.  Pediatr Neurol. 2006;  34 110-115
• 28 Wade DT. Epidemiology of disabling neurological disease: how and why does disability occur?.  J Neurol Neurosurg Psych. 1997;  63 11-18
• 29 Wang SJ, Fuh JL, Lu SR. et al . Chronic daily headache in adolescents. Prevalence, impact, and medication overuse.  Neurology. 2006;  66 193-197

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