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


METHODS
All patients aged > or =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.


RESULTS
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 > or =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).


CONCLUSIONS
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.
Kotsopoulos
Irene
I
Department of Neurology, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. iko@sneu.azm.nl
de Krom
Marc
M
Kessels
Fons
F
Lodder
Jan
J
Troost
Jaap
J
Twellaar
Mascha
M
van Merode
Tiny
T
Knottnerus
André
A
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004827:Epilepsy / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012640:Seizures / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D017678:Sex Distribution