Department of Public Health and Child Neurology, University of Turku, Turku, Finland.
Epilepsia. 2011 Oct;52(10):1857-67. doi: 10.1111/j.1528-1167.2011.03186.x. Epub 2011 Jul 21.
Regional variations and temporal trends in the incidence of new-onset epilepsy are clinically important and may offer clues on how to prevent epilepsy.
We examined regional differences and secular trends in the incidence of new-onset epilepsy in the Finnish population based on the nationwide full-refundable antiepileptic drug registry and the population registry in the years 1986-2008.
The overall incidence of epilepsy was significantly higher in eastern Finland than in middle [risk ratio (RR) 1.08 (95% confidence interval, CI 1.05-1.12)), p < 0.0001] and western Finland [RR 1.32 (1.30-1.35), p < 0.0001] but it was declining from 1986 to 2008 in all regions [RR 0.83 (0.81-0.84), p < 0.0001]. The mean annual decline was 0.6%. Although the incidence of epilepsy was falling from 1986 to 2008 in childhood [annual decline 1.9%, RR 0.80 (0.75-0.86), p < 0.0001] and in middle age [annual decline 0.8%, RR 0.88 (0.84-0.93), p < 0.0001], it increased significantly in the elderly (age 65 years or older) in all of Finland [annual increase 3.5%, RR 1.25 (1.18-1.33), p < 0.0001], and particularly in east versus west Finland [RR 1.48 (1.42-1.55), p < 0.0001]. As a result, starting with the year 2000, the incidence rate of epilepsy was higher in the elderly than in children for all of Finland.
In view of the falling incidence of epilepsy in childhood and middle-age in all of Finland from 1986 to 2008, the significant increase in the incidence of epilepsy in the elderly is of concern. The regional increase of epilepsy may offer clues for allocating resources and, possibly, population epileptogenesis between west and east Finland and for strategies to prevent epilepsy in the elderly.
新发性癫痫发病率的地域差异和时间趋势具有重要的临床意义，可能为预防癫痫提供线索。
我们根据全国性全额报销抗癫痫药物登记处和人口登记处，对 1986 年至 2008 年芬兰人群中新发性癫痫发病率的地域差异和时间趋势进行了研究。
与芬兰中西部（风险比[RR]1.08（95%置信区间[CI]1.05-1.12），p<0.0001）相比，芬兰东部癫痫的总体发病率显著更高[RR 1.08（95%置信区间[CI]1.05-1.12），p<0.0001]，而芬兰西部[RR 1.32（1.30-1.35），p<0.0001]，但所有地区的发病率都呈下降趋势[RR 0.83（0.81-0.84），p<0.0001]。从 1986 年到 2008 年，平均每年下降 0.6%。尽管 1986 年至 2008 年期间，儿童[年下降 1.9%，RR 0.80（0.75-0.86），p<0.0001]和中年[年下降 0.8%，RR 0.88（0.84-0.93），p<0.0001]癫痫的发病率在下降，但芬兰所有地区老年人（65 岁及以上）的发病率显著增加[每年增加 3.5%，RR 1.25（1.18-1.33），p<0.0001]，尤其是在芬兰东部与西部相比[RR 1.48（1.42-1.55），p<0.0001]。因此，自 2000 年起，芬兰所有地区老年人的癫痫发病率高于儿童。
鉴于芬兰所有地区的儿童和中年癫痫发病率从 1986 年至 2008 年呈下降趋势，老年人癫痫发病率的显著增加令人担忧。癫痫发病率的地域差异可能为资源分配提供线索，并可能为芬兰西部和东部之间的人群癫痫发生提供线索，也可能为预防老年人癫痫提供策略。
