A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Efforts in Epilepsy Prevention in the Last 40 Years Lessons From a Large Nationwide Study
Tekijät: Matti Sillanpää, Mika Gissler, Dieter Schmidt
Julkaisuvuosi: 2016
Journal: JAMA Neurology
Vuosikerta: 73
Numero: 4
Aloitussivu: 390
Lopetussivu: 395
Sivujen määrä: 6
ISSN: 2168-6149
DOI: https://doi.org/10.1001/jamaneurol.2015.4515
Tiivistelmä
IMPORTANCE Prevention of new-onset epilepsy is an important public health issue and
presents a pressing unmet need. It is unclear whether progress has been made in preventing
new-onset epilepsy.
OBJECTIVE To determine whether progress has been made in the prevention of epilepsy in
Finland during the last 40 years.
DESIGN, SETTING, AND PARTICIPANTS Using a long-term national register study of 5.04 million
Finnish individuals, we looked at first-time inpatient admissions in Finland for a diagnosis of
epilepsy from 1973 to 2013. Patients with epilepsy were defined by the occurrence of 2 or
more unprovoked seizures. This study was conducted on July 29, 2015.
MAIN OUTCOMES AND MEASURES In Finland, patients with epilepsy are routinely hospitalized
at time of diagnosis, thus providing evidence for the incidence of epilepsy.
RESULTS Of the mean 5.04 million Finnish individuals followed up for the development of
epilepsy from 1973 to 2013, 100 792 people were identified as having epilepsy. Of these,
46 995 (47%) had focal epilepsy. The mean age for those included in the study was 45 years
for men (interquartile range, 24-65 years) and 46 years for women (interquartile range, 23-71
years).We found no change in the incidence of epilepsy in the age range of those younger
than 65 years (60 per 100 000 in 1973 and 64 per 100 000 in 2013). However, there was a
significant increase in epilepsy among those older than 65 years (from 57 per 100 000 to 217
per 100 000).
CONCLUSIONS AND RELEVANCE We found no evidence that progress has been made in
preventing new-onset epilepsy in those younger than 65 years in the last 40 years; in fact,
there was a nearly 5-fold rise of new-onset epilepsy among the elderly population.
IMPORTANCE Prevention of new-onset epilepsy is an important public health issue and
presents a pressing unmet need. It is unclear whether progress has been made in preventing
new-onset epilepsy.
OBJECTIVE To determine whether progress has been made in the prevention of epilepsy in
Finland during the last 40 years.
DESIGN, SETTING, AND PARTICIPANTS Using a long-term national register study of 5.04 million
Finnish individuals, we looked at first-time inpatient admissions in Finland for a diagnosis of
epilepsy from 1973 to 2013. Patients with epilepsy were defined by the occurrence of 2 or
more unprovoked seizures. This study was conducted on July 29, 2015.
MAIN OUTCOMES AND MEASURES In Finland, patients with epilepsy are routinely hospitalized
at time of diagnosis, thus providing evidence for the incidence of epilepsy.
RESULTS Of the mean 5.04 million Finnish individuals followed up for the development of
epilepsy from 1973 to 2013, 100 792 people were identified as having epilepsy. Of these,
46 995 (47%) had focal epilepsy. The mean age for those included in the study was 45 years
for men (interquartile range, 24-65 years) and 46 years for women (interquartile range, 23-71
years).We found no change in the incidence of epilepsy in the age range of those younger
than 65 years (60 per 100 000 in 1973 and 64 per 100 000 in 2013). However, there was a
significant increase in epilepsy among those older than 65 years (from 57 per 100 000 to 217
per 100 000).
CONCLUSIONS AND RELEVANCE We found no evidence that progress has been made in
preventing new-onset epilepsy in those younger than 65 years in the last 40 years; in fact,
there was a nearly 5-fold rise of new-onset epilepsy among the elderly population.
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