Association between inflammatory central nervous system diseases and epilepsy: A retrospective cohort study of 4252 patients in Germany

• Published in: Epilepsy & behavior Vol. 117; p. 107879
• Main Authors: Jacob, Louis, Koyanagi, Ai, Haro, Josep Maria, Konrad, Marcel, Uepping, Peter, Kostev, Karel
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2021; [San Diego CA]: Elsevier B.V
• Subjects: Adolescent; Adult; Central Nervous System Diseases - complications; Central Nervous System Diseases - epidemiology; Encephalitis; Epilepsy; Epilepsy - complications; Epilepsy - epidemiology; Female; Germany; Germany - epidemiology; Humans; Inflammatory central nervous system diseases; Life Sciences; Male; Middle Aged; Retrospective cohort study; Retrospective Studies; Santé publique et épidémiologie; Germany; ATC; ICD-10; Inflammatory central nervous system diseases; EphMRA; Epilepsy; Retrospective cohort study; CNS; Germany
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2021.107879

•This study included 4252 individuals with or without inflammatory CNS disease.•There was a significant association between inflammatory CNS diseases and epilepsy.•Epilepsy should be regularly screened in patients with inflammatory CNS disorders.
The goal of this study was to analyze the association between inflammatory central nervous system (CNS) diseases and the incidence of epilepsy in patients followed up for up to 10 years in Germany.
This retrospective cohort study included adults aged ≥ 18 years who had an initial diagnosis of inflammatory CNS disease (i.e. encephalitis, meningitis or brain abscess) in one of 1229 general practices in Germany between 2005 and 2015 (index date). Patients without inflammatory CNS disease were matched (1:1) to those with inflammatory CNS disease by sex, age, follow-up time after index date, Charlson Comorbidity Index, and practice. The index date for patients without inflammatory CNS disease was a randomly selected visit date between 2005 and 2015. Kaplan–Meier curves and Cox regression analyses were used to assess the association between inflammatory CNS diseases and the incidence of epilepsy.
This study included 2126 individuals with and 2126 patients without inflammatory CNS disease (56.4% women; mean [SD] age 50.0 [12.3] years). Within ten years of the index date, 4.2% of patients with and 1.5% of patients without inflammatory CNS disease had been diagnosed with epilepsy (p < 0.001). This finding was corroborated in the Cox regression analysis, and there was a positive and significant association between inflammatory CNS diseases and epilepsy (HR: 3.82, 95% CI: 2.24–6.52).
Based on these results, preventive interventions are urgently warranted to reduce the incidence of epilepsy in individuals with a history of inflammatory CNS disease.