Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Epilepsy Behav. 2013 Nov;29(2):374-8. doi: 10.1016/j.yebeh.2013.08.013. Epub 2013 Sep 30.
To determine whether the diagnosis of hypertensive encephalopathy (HE) is linked to an increased risk of subsequent epilepsy by using a nationwide population-based retrospective study.
Our study featured a study cohort and a comparison cohort. The study cohort consisted of all patients with newly diagnosed HE between 1997 and 2010, compiled from universal insurance claims data on patients with hypertension taken from the National Health Insurance Research Database. The comparison cohort comprised the remaining hypertensive patients without encephalopathy. The follow-up period was terminated following the development of epilepsy, death, withdrawal from the National Health Insurance system, or the end of 2010. We determined the cumulative incidences and hazard ratios (HRs) of epilepsy development.
The incidence of subsequent epilepsy was 2.25-fold higher in the patients with HE than in comparisons (4.17 vs. 1.85 per 1000 person-years), with an adjusted HR of 2.06 (95% CI=1.66-2.56) in the multivariable Cox proportional-hazards regression analysis. The incidence of epilepsy was higher in men, younger patients with HE, and those with brain disorders.
We found that, in Taiwan, patients with HE are at an increased risk of subsequent epilepsy. Physicians should be aware of HE's link to epilepsy when assessing patients with HE.
通过一项全国范围内基于人群的回顾性研究，确定高血压性脑病 (HE) 的诊断是否与随后发生癫痫的风险增加有关。
我们的研究包括一个研究队列和一个对照组。研究队列由 1997 年至 2010 年间新诊断为 HE 的所有患者组成，这些患者的信息均来自国家健康保险研究数据库中高血压患者的全民保险索赔数据。对照组由无脑病的其余高血压患者组成。随访期在发生癫痫、死亡、退出国家健康保险系统或 2010 年底结束。我们确定了癫痫发展的累积发生率和风险比 (HR)。
与对照组相比，HE 患者发生后续癫痫的风险高出 2.25 倍（每 1000 人年 4.17 比 1.85），多变量 Cox 比例风险回归分析的调整 HR 为 2.06（95%CI=1.66-2.56）。男性、HE 年轻患者和伴有脑部疾病的患者癫痫发病率更高。
我们发现，在台湾，HE 患者发生后续癫痫的风险增加。医生在评估 HE 患者时应意识到 HE 与癫痫之间的关联。
