title: Male, old age and low income to predispose epilepsy in migraineurs.
abstract: BACKGROUND
  This study investigated whether sex, age, income and any comorbidity affect subsequent epilepsy development in migraineurs.
  
  
  METHODS
  A total of 4915 men diagnosed with migraine who were aged older than 20 years were identified as the study cohort. A total of 4882 female migraineurs were included in the comparison cohort. We calculated the adjusted hazard ratio (aHR) for the risk of epilepsy in the two cohorts after adjustment for age and comorbidity. Kaplan-Meier analysis was used to analyse the cumulative epilepsy incidence, and the log-rank test was used to estimate the differences between the two cumulative incidence curves.
  
  
  RESULTS
  The risk of epilepsy was 2·31-fold higher in male migraineurs than in female migraineurs. The income-specific analysis showed that the risk of epilepsy was high in migraineurs with a low monthly income [aHR: 2·73 for 15 000-25 000 new Taiwan dollar (NTD; approximately 500-833 USD) and aHR: 2·71 for < 15 000 NTD]. Among patients with one or more comorbidity, a 2·48-fold (95% confidence interval: 1·65-3·74) high risk of epilepsy was noted in male migraineurs, regardless of the presence of head injury. Additional analyses revealed that male migraineurs aged 65 years or older had the highest risk of epilepsy.
  
  
  CONCLUSIONS
  Migraineurs have an increased risk of subsequent epilepsy. Male sex, old age and low income may interact with migraine and result in a high risk of epilepsy in migraineurs.
authors.affiliation: Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.|College of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Tomor
authors.initials: T
authors.lastname: Harnod
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Yu-Chiao
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chun-Hung
authors.initials: CH
authors.lastname: Tseng
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D001932:Brain Neoplasms / Q000453:epidemiology; D015897:Comorbidity; D006259:Craniocerebral Trauma / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology*; D011203:Poverty / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Cohort study; National Health Insurance; epilepsy; low income; migraine