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Epilepsy in multiple sclerosis: A nationwide population-based register study.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.ORCID iD: 0000-0002-7045-1806
University of Gothenburg, Sahlgrenska Academy, Department of Clinical Neuroscience, Gothenburg.; Sahlgrenska University Hospital, Gothenburg.
2017 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 89, no 24, p. 2462-2468Article in journal (Refereed) Published
Abstract [en]

Objective: To determine the cumulative incidence of epilepsy in a population-based cohort of patients with multiple sclerosis (MS) and to investigate the association between epilepsy and clinical features of MS.

Methods: All available patients in the Swedish MS register (n = 14,545) and 3 age- and sex-matched controls per patient randomly selected from the population register (n = 43,635) were included. Data on clinical features of MS were retrieved from the Swedish MS register, and data on epilepsy and death were retrieved from comprehensive patient registers.

Results: The cumulative incidence of epilepsy was 3.5% (95% confidence interval [CI] 3.17–3.76) in patients with MS and 1.4% (95% CI 1.30–1.52) in controls (risk ratio 2.5, 95% CI 2.19–2.76). In a Cox proportional model, MS increased the risk of epilepsy (hazard ratio 3.2, 95% CI 2.64–3.94). Patients with relapsing-remitting MS had a cumulative incidence of epilepsy of 2.2% (95% CI 1.88–2.50), whereas patients with progressive disease had a cumulative incidence of 5.5% (95% CI 4.89–6.09). The cumulative incidence rose continuously with increasing disease duration to 5.9% (95% CI 4.90–7.20) in patients with disease duration ≥34 years. Patients with an Expanded Disability Status Scale (EDSS) score ≥7 had a cumulative incidence of epilepsy of 5.3% (95% CI 3.95–7.00). Disease duration and EDSS score were associated with epilepsy after multiple logistic regression (odds ratio [OR] 1.03, 95% CI 1.01–1.04 per year, p = 0.001; and OR 1.2, 95% CI 1.09–1.26 per EDSS step, p < 0.0001).

Conclusions: Epilepsy is more common among patients with MS than in the general population, and a diagnosis of MS increases the risk of epilepsy. Our data suggest a direct link between severity of MS and epilepsy.

Place, publisher, year, edition, pages
2017. Vol. 89, no 24, p. 2462-2468
National Category
Neurology Neurosciences
Identifiers
URN: urn:nbn:se:uu:diva-336516DOI: 10.1212/WNL.0000000000004740ISI: 000423335100015PubMedID: 29117950OAI: oai:DiVA.org:uu-336516DiVA, id: diva2:1166095
Funder
Swedish Society of MedicineAvailable from: 2017-12-14 Created: 2017-12-14 Last updated: 2018-03-23Bibliographically approved

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Burman, Joachim

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