Matti Sillanpää1, Mika Gissler2, Dieter Schmidt3. 1. Departments of Public Health and Child Neurology, University of Turku, Turku, Finland. 2. National Institute of Health and Welfare, Helsinki, Finland. 3. Epilepsy Research Group, Berlin, Germany.
Abstract
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.