Risk factors for a first generalized tonic-clonic seizure in adult life.
To evaluate risk factors for a first generalized tonic-clonic seizure (GTCS) in adults (=15 years), we performed a multicenter, case-control study involving eleven first-referral neurological departments in north-western Italy. The study enrolled 278 patients with a first GTCS, and 556 age- and sex-matched hospital controls. Cases and controls were interviewed through a questionnaire (inter-rater and index-proxy agreement varied between 75% and 100% for the different questions). Risk factors significantly associated with a first GTCS were: severe head trauma (odds ratio 9.9; 95% confidence limits 2.0-67.1), siblings with seizures (5.7; 1.7-21.4), alcohol intake >50 grams/day (4.9; 3.1-7.9), history of stroke (3.8; 1.8-8.0), complications of delivery (2.7; 1.5-5.1), other relatives with seizures (2.4; 1.3-4.6), sleep deprivation (2.4; 1.4-4.1), low gestational age (1.9; 1.1-3.4), mild-moderate head trauma (1.8; 1.2-3.0), and low birth weight (1.6; 1.0-2.7). Genetic and late acquired factors and life habits are major risk factors for a first GTCS in adults, while pre- and perinatal events play only a minor role.
Leone
M
M
Neurology Clinic, Ospedale Maggiore, Corso Mazzini 18, I-28100 Novara, Italy.
Bottacchi
E
E
Beghi
E
E
Morgando
E
E
Mutani
R
R
Cremo
R
R
Ravagli Ceroni
L
L
Floriani
I
I
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000437:Alcoholism / Q000150:complications; D016022:Case-Control Studies; D006259:Craniocerebral Trauma / Q000150:complications; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D015203:Reproducibility of Results; D012307:Risk Factors; D012892:Sleep Deprivation / Q000150:complications; D020521:Stroke / Q000150:complications; D011795:Surveys and Questionnaires