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Prior hospitalization for stroke, diabetes, myocardial infarction, and subsequent risk of unprovoked seizures
Author(s) -
Adelöw Cecilia,
Andersson Tomas,
Ahlbom Anders,
Tomson Torbjörn
Publication year - 2011
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2010.02757.x
Subject(s) - medicine , myocardial infarction , odds ratio , stroke (engine) , epilepsy , population , diabetes mellitus , pediatrics , subarachnoid hemorrhage , confidence interval , cohort study , psychiatry , endocrinology , environmental health , engineering , mechanical engineering
Summary Purpose: 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.