title: Increased risk of epilepsy among patients diagnosed with chronic osteomyelitis.
abstract: OBJECTIVE
  Inflammatory processes, which raise the unsteadiness of brain neuron membrane potentials, might enhance the development of epilepsy. Inflammation is a substantial indicator of epilepsy risk. In this study, we evaluated whether chronic osteomyelitis (COM), a chronic inflammatory disease, increases epilepsy risk.
  
  
  METHODS
  A Taiwanese national insurance claims dataset of more than 22 million enrollees was used to select 20,996 COM patients and 83,973 randomly selected age- and gender-matched controls to investigate epilepsy development over an 11-year follow-up period, starting on January 1, 2000 and ending on December 31, 2010. The epilepsy risk was analyzed using a Cox proportional hazards regression model.
  
  
  RESULTS
  Comorbidities known to elevate epilepsy risk, including diabetes, hypertension, head injury, stroke, and cancer, were commonly noted in the COM cohort, which had considerably higher risk of epilepsy than did the control group. Comparing only those without comorbidities, COM patients still exhibited higher epilepsy risk than the control group did (adjusted hazard ratio [aHR]=3.87, 95% confidence interval [CI]: 3.01-4.98). The younger population exhibited an even greater risk (age ≤39 years: aHR=6.10, 95% CI: 4.00-9.30; age ≥65 years: aHR=1.66, 95% CI: 1.28-2.16).
  
  
  CONCLUSIONS
  This is the first study linking COM to an increased risk in epilepsy development. The results demonstrated that COM is a significant predictor of epilepsy. Further study of COM patients, particularly young patients, is recommended to facilitate epilepsy prevention.
authors.affiliation: Department of Neurology, China Medical University Hospital, Taichung 40447, Taiwan; School of Medicine, China Medical University, College of Medicine, Taichung 40402, Taiwan.
authors.forename: Chun-Hung
authors.initials: CH
authors.lastname: Tseng
authors.affiliation: Department of Neurology, China Medical University Hospital, Taichung 40447, Taiwan; School of Medicine, China Medical University, College of Medicine, Taichung 40402, Taiwan.
authors.forename: Wei-Shih
authors.initials: WS
authors.lastname: Huang
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan.
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.affiliation: Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 40447, Taiwan; School of Medicine, China Medical University, College of Medicine, Taichung 40402, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Chronic osteomyelitis; Epilepsy; Inflammation