Incidence of epilepsy and predictive factors of epileptic and non-epileptic seizures

• Published in: Seizure (London, England) England), 2005-04, Vol.14 (3), p.175-182
• Main Authors: Kotsopoulos, Irene, de Krom, Marc, Kessels, Fons, Lodder, Jan, Troost, Jaap, Twellaar, Mascha, van Merode, Tiny, Knottnerus, André
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Cross-Sectional Studies; Diagnosis, Differential; Electroencephalography; Epidemiology; Epilepsy; Epilepsy - classification; Epilepsy - diagnosis; Epilepsy - epidemiology; Epilepsy - physiopathology; Female; Humans; Incidence; Logistic Models; Male; Middle Aged; Netherlands - epidemiology; Non-epileptic seizures; Odds Ratio; Predictive factors; Predictive Value of Tests; Prospective Studies; Seizures - classification; Seizures - diagnosis; Seizures - epidemiology; Seizures - physiopathology; Sex Distribution; Unprovoked seizures
• ISSN: 1059-1311; 1532-2688
• DOI: 10.1016/j.seizure.2005.01.005

To estimate the incidence of unprovoked seizures (US) and epilepsy in a general population from the southern part of the Netherlands, in relation to age, sex, etiology and seizure type, and to identify predictive factors of the epileptic and non-epileptic seizures. All patients aged ≥14 years with a first seizure or who had undiagnosed seizures before the study period were included. Patients were identified from different sources and were independently evaluated and classified by a team of neurologists. A predictive profile for the occurrence of epileptic and non-epileptic seizures was obtained by stepwise logistic regression analysis. The overall annual incidence was 55/100,000 and 30/100,000 for US and epilepsy, respectively. The age-specific annual incidence of US and epilepsy increased with age and reached 120/100,000 and 62/100,000 for the ≥65 years of age group, respectively. The incidence of epilepsy and US in males was higher than in females and partial seizures prevailed over generalized seizures (40 versus 9/100,000). In up to 35% of the cases with US or epilepsy, the etiology was mainly cerebrovascular disease and brain tumors. Predictors for epileptic versus non-epileptic seizures of organic origin were an epileptiform EEG pattern (OR = 0.06) versus a history of hypertension (OR = 2.8) or cardiovascular disease (OR = 5.4). Strong predictors for seizures of non-organic origin were female sex (OR = 2.2) and head injury (OR = 2.4). The incidence of US and epilepsy (overall, and age-, sex-, seizure-specific) was similar to those reported by other developed countries. The predictive factors found in this study may assist in the early diagnosis of seizures.