The increased rate of psychiatric comorbidity predating and succeeding seizure onset indicates a bidirectional relationship and common underlying mechanisms for psychiatric disorders and epilepsy.

Summary Purpose:  To describe and report initial findings of a system for prospective identification and follow‐up of patients with newly diagnosed single unprovoked seizures and epilepsy in Stockholm, Sweden, the Stockholm Incidence Registry of Epilepsy (SIRE). Methods:  From September 2001 through August 2004, a surveillance system has been in use to identify incident cases of first unprovoked seizures (neonatal seizures excluded) and epilepsy among residents of Northern Stockholm, an urban area with approximately 998,500 inhabitants. Potential cases are identified through multiple mechanisms: Network of health care professionals, medical record screening in specific hospital units, including outpatient clinics, emergency room services, and review of requests for electroencephalography (EEG) examination. Potential cases are classified 6 months after the index seizure based on review of medical records. Results:  After screening approximately 10,500 EEG requests and 3,300 medical records, 1,015 persons met the criteria for newly diagnosed unprovoked seizures (430 single seizures; 585 epilepsy). The crude incidence for first unprovoked seizures and epilepsy was 33.9/100,000 person years, (the same adjusted to the European Standard Million), highest the first year of life (77.1/100,000) and in the elderly. No cause could be identified in 62.4%. Conclusions:  We have established a sustainable system for prospective identification of new onset epilepsy cases in Stockholm. Despite a possible under‐ascertainment, the registry provides a useful starting point for follow‐up studies.

Relative risks (RRs) for unprovoked seizures were estimated after various TBI diagnoses, and influences of TBI severity and time since trauma were studied in detail. Results: After hospitalization for mild TBI, the RR was 2.0 (95% confidence interval [CI] 1.5-2.7). The RR was higher after brain contusion (5.9, 95% CI 2.4-15.0) or intracranial hemorrhage (ICH) (4.5, 95% CI 2.2-9.0), whereas a combination of both diagnoses led to a further sevenfold increase in RR (42.6, 95% CI 12.2-148.5). The risk was greatest during the first 6 months after severe TBI (RR 48.9, 95% CI 10.9-218.9) or mild TBI (RR 8.1, 95% CI 3.1-21.7), but was still elevated >10 years after any TBI. Significance: Herein we present a large population-based case-control study on TBI as a risk factor for unprovoked epileptic seizures, including cases of all ages with individually validated seizure diagnoses. The risk for epileptic seizures was substantially increased after TBI, especially during the first 6 months after the injury and in patients with a combination of ICH and brain contusion.

No abstract

SUMMARYPurpose: To study diabetes, acute myocardial infarction, and stroke as risk factors for unprovoked seizures in a population-based cohort with incident cases of epilepsy. Methods: In this nested case-control study, the cases were 933 patients with newly diagnosed unprovoked seizures from the Stockholm Incidence Registry of Epilepsy. Controls, in total 6,039-matched for gender, year of diagnosis, and catchment area-were randomly selected from the register of the Stockholm County population. A history of diabetes, myocardial infarction, and stroke preceding the date of onset of seizure was determined by search of the Swedish Hospital Discharge Registry. Odds ratios (ORs) were calculated to assess the risk of developing unprovoked seizures after hospital admission for any of these diagnoses. Results: The age-adjusted OR (95% confidence interval, 95% CI) for unprovoked seizures after a discharge diagnosis of diabetes was 1.9 (95% CI 1.4-2.8) and after acute myocardial infarction 1.7 (95% CI 1.0-2.9). The OR was 9.4 (95% CI 6.7-13.1) after cerebral infarction, 7.2 (95% CI 3.9-13.6) after intracerebral hemorrhage, 7.2 (95% CI 2.9-18.1) after subarachnoid hemorrhage, and 3.2 (95% CI 1.9-5.5) after transient ischemic attack. The population attributable risk percent (PAR%) was <2% for each of the diagnoses except for cerebral infarction, for which the PAR% was 9%. Taken together the studied diagnoses accounted for 15% of the incident cases of unprovoked seizures. Discussion: As previously known, the risk for unprovoked seizures and epilepsy after a cerebral infarction was highest the first year after the infarction. This risk remained substantial >7 years after a diagnosis of cerebral infarction.

No abstract

No abstract

No abstract