Public Health and Regulatory Policy, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Epilepsia. 2010 Jul;51(7):1177-84. doi: 10.1111/j.1528-1167.2009.02426.x. Epub 2010 Jan 13.
The purpose of this research was to analyze and quantify the association between alcohol consumption and epilepsy as an independent disease, in part operationalized by the occurrence of unprovoked seizures, as well as to examine causality.
Systematic review, meta-analysis.
A strong and consistent association between alcohol consumption and epilepsy/unprovoked seizures was found with an overall relative risk (RR) of 2.19 [95% confidence interval (CI) 1.83-2.63]. There was a dose-response relationship between the amount of alcohol consumed daily and the probability of the onset of epilepsy. Individuals consuming an average of four, six, and eight drinks daily had RRs of 1.81 (95% CI 1.59-2.07), 2.44 (95% CI 2.00-2.97), and 3.27 (95% CI 2.52-4.26), respectively, compared to nondrinkers. Several pathogenic mechanisms for the development of epilepsy in alcohol users were identified. Most of the relevant studies found that a high percentage of alcohol users with epilepsy would qualify for the criteria of alcohol dependence. Data were inconclusive regarding a threshold for the effect of alcohol, but most studies suggest that the effect may only hold for heavy drinking (four and more drinks daily).
The relationship between alcohol consumption and epilepsy and unprovoked seizures was quantified and several pathogenic mechanisms were suggested, although none of them has been proven to be the unique causative pathway for epilepsy. Certain limitations underlying this study require further research to clarify the outstanding statistical issues and pathogenesis of epilepsy in heavy drinkers.
本研究旨在分析和量化酒精摄入与癫痫作为一种独立疾病之间的关联，部分通过自发性癫痫发作的发生来操作化，同时也研究因果关系。
系统回顾，荟萃分析。
发现酒精摄入与癫痫/自发性癫痫发作之间存在强烈而一致的关联，总体相对风险（RR）为 2.19（95%置信区间[CI] 1.83-2.63）。酒精摄入量与癫痫发病概率之间存在剂量-反应关系。每日平均饮用四、六和八杯酒的个体的 RR 分别为 1.81（95%CI 1.59-2.07）、2.44（95%CI 2.00-2.97）和 3.27（95%CI 2.52-4.26），与不饮酒者相比。确定了酒精使用者中癫痫发生的几种发病机制。大多数相关研究发现，有很大比例的酒精使用癫痫患者符合酒精依赖的标准。关于酒精效应的阈值数据尚无定论，但大多数研究表明，这种效应可能仅适用于大量饮酒（每日四杯或更多）。
定量了酒精摄入与癫痫和自发性癫痫发作之间的关系，并提出了几种发病机制，尽管没有一种被证明是癫痫的独特致病途径。本研究存在某些局限性，需要进一步研究以阐明大量饮酒者癫痫的突出统计学问题和发病机制。
