Parkinson disease and the risk of epileptic seizures

作者：Gruntz Katharina; Bloechliger Marlene; Becker Claudia; Jick Susan S; Fuhr Peter; Meier Christoph R^*; Ruegg Stephan

来源：Annals of Neurology, 2018, 83(2): 363-374.

DOI：10.1002/ana.25157

ObjectiveTo assess the association between incident Parkinson disease (PD) and subsequent incident epileptic seizures.
MethodsWe conducted a retrospective cohort study with a nested case-control analysis using data from the U.K. Clinical Practice Research Datalink. We identified patients aged 40 years with an incident diagnosis of PD between 1995 and 2016 and a matched comparison group of PD-free individuals. We calculated crude incidence rates (IRs) with 95% confidence intervals (CIs) of epileptic seizures in PD patients and the PD-free comparison group, and corresponding crude incidence rate ratios (IRRs). In the nested case-control analysis, we calculated adjusted odds ratios (adj. ORs) of incident PD among cases with incident epileptic seizures and seizure-free controls overall and stratified by various seizure-provoking comorbidities.
ResultsAmong 23,086 incident PD patients and 92,343 PD-free individuals, we identified 898 patients with incident epileptic seizures. The crude IR of epileptic seizures in PD patients was 266.7/100,000 person-years (95% CI=235.6-297.7), and in PD-free individuals it was 112.4/100,000 person-years (95% CI=103.5-121.3; IRR=2.37, 95% CI=2.06-2.73). The adj. OR of epileptic seizures was 1.68 (95% CI=1.43-1.98) in PD patients compared with PD-free individuals. PD patients with comorbid brain disorders (adj. OR=12.36, 95% CI=8.74-17.48) or with>1 seizure-provoking comorbidity (adj. OR=13.24, 95% CI=10.15-17.25) were at the highest risk of epileptic seizures compared with PD-free individuals with no seizure-provoking comorbidities.
InterpretationThis study suggests that incident PD is associated with an increased risk of incident epileptic seizures. Ann Neurol 2018;83:363-374

• 出版日期2018-2