Newly‐diagnosed epileptic seizures in three populations: Geneva (EPIGEN), Martinique (EPIMART), and the Reunion Island (EPIREUN)

Abstract

The objective was to analyse and discuss data from three studies of newly-diagnosed epileptic seizures (provoked and unprovoked) conducted in Geneva, Martinique, and the Reunion Island, in which the same methodology was used. Methods. We extracted data from three studies in which the incidence of seizures was estimated and aetiologies identified. Data was extracted and analysed using STATA. Group comparison was performed firstly for each study as a single group, and secondly by considering Martinique and the Reunion Island as an overseas group, in comparison with Geneva, considered as a mainland group. Uncorrected 2 was used and statistical significance (two-sided, p=0.05) was determined for each aetiology per cohort. Results. The incidence of newlydiagnosed epileptic seizures per 100,000 was 71.0, 80.6, and 100.4 in Geneva, Martinique, and the Reunion Island, respectively. A bimodal distribution and predominance of generalised seizures was noted. The male to female ratio was higher in Martinique (∼2.0) than other populations (∼1.5). Status epilepticus was noted in Geneva and more so in the Reunion Island. The incidence of provoked seizures per 100,000 was 25.2, 16.4, and 17.7, and for unprovoked seizures was 45.6, 64.1, and 81.2 in Geneva, Martinique, and the Reunion Island, respectively. There was a greater risk of provoked seizures in Geneva relative to the overseas group, which was due to tumours, use of toxic substances, and drug abuse. The risk of unprovoked seizures in Geneva was due to trauma and infections. In Martinique, alcoholism and HIV were foremost factors for provoked and unprovoked seizures, and

Epidemiology of First Epileptic Seizures in the Northern Aegean Island of Lesvos, Greece

“…10 The epidemiologic profile of first epileptic seizures in the present study is comparable to that established in the majority of studies on populations covered by a well-developed healthcare infrastructure. 1,8,12 Thus, the present results indicated a bimodal distribution in seizure incidence rates across age groups with an initial peak at the youngest age group (0-9 years), followed by a decline in incidence rates and a steep increase at age groups of 60 years and over. Additionally, the present findings showed a predominance of unprovoked over provoked seizures and a substantial male predominance in occurrence.…”

“…1,8 The incidence of unprovoked first seizures in the studied population (35.9 per 10 5 ) is at the low end of the range of estimates established by previous studies following ILAE guidelines (range: 23 to 81/ 10 5 ). 1,8 Moreover, the incidence of provoked seizures (16.2 per 10 5 ) represents one of the lowest estimates thus far reported. 1,8 In this context it is noteworthy that cases related to common etiologic factors, such as drug and alcohol abuse and/or withdrawal, 8 were not identified.…”

“…Nevertheless, such studies can provide valuable insights for the identification of high-risk groups and development of preventive strategies. 1,8 The present study investigated the incidence of first epileptic seizures, their etiology and treatment in the Greek island of Lesvos. An earlier prospective population-based study conducted in Greece, indicated a relatively low incidence of first unprovoked epileptic seizures in a Greek island complex (Corfu district).…”

“…Unprovoked seizures were subdivided into three categories: those of unknown etiology (termed idiopathic or cryptogenic) and those associated with either a known static neurological condition or a progressive CNS disorder (the latter two categories termed remote symptomatic). 8 Febrile seizures occurring in children and neonates were excluded from the present analysis.…”

“…7-9 Nonetheless, common themes that emerge from the preponderance of epidemiological evidence on epileptic seizures for populations with well-developed healthcare infrastructures include a bimodal distribution across age groups and a predominance of unprovoked over provoked seizures. 1,8 …”