Wallace H, Shorvon S, Tallis R
Epilepsy Research Group, Institute of Neurology, University College London, National Hospital for Neurology and Neurosurgery, UK.
Lancet. 1998;352(9145):1970-3. doi: 10.1016/S0140-6736(98)04512-7.
There are no data on prevalence or incidence of treated epilepsy, and no data on fertility of women with epilepsy from an unselected UK population.
We used the General Practice Research Database to ascertain the incidence and prevalence of people with treated epilepsy in an unselected population of 2,052,922 people in England and Wales, and also age-specific fertility rates. We defined period prevalence of treated epilepsy as the number of people with epilepsy taking an antiepileptic drug per 100,000 people during 1995. The incidence of treated epilepsy was defined as the number of new cases of treated epilepsy per 100,000 people during the same period. We calculated fertility rates among women with treated epilepsy between 1991 and 1995 and compared these rates with the population rates for England and Wales in 1993.
The period prevalence of treated epilepsy in 1995 was 5.15 per 1000 people (95% CI 5.05-5.25). The prevalence was lower in children (age 5-9 years 3.16 [2.86-3.48]; 10-14 years 4.05 [3.70-4.42]), and higher in older people (65-69 years 6.01 [5.50-6.57]; 70-74 years 6.53 [5.97-7.14]; 75-79 years 7.39 [6.73-8.11]); 80-84 years 7.54 [6.78-8.39]; 85 years and older 7.73 [6.98-8.66]). The incidence of treated epilepsy was 80.8 per 100,000 people (76.9-84.7). The incidence was lower in children (5-9 years 63.2 [50.5-79.1]; 10-14 years 53.8 [42.4-68.3]) and higher in older people (65-69 years 85.9 [68.5-107.3]; 70-74 years 82.8 [65.0-105.2]; 75-79 years 114.5 [116.9-179.2]; 80-84 years 159 [125.2-202.6]; > or = 85 years 135.4 [100.4-178.7]). Fertility was lower among women with treated epilepsy, with an overall rate of 47.1 livebirths per 1000 women aged 15-44 per year (42.3-52.2), compared with a national rate of 62.6 in the same age-group. The standardised fertility ratios were significantly lower between the ages of 25 and 39 years in women with epilepsy (p<0.001).
Compared with previous studies, we found that the incidence of epilepsy was higher in elderly people and lower in children. The prevalence rates also increase with age. Women aged 25-39 years with treated epilepsy have significantly lower fertility rates than those in the general population. Research is needed to identify any potentially preventable causes for the low fertility rates.
目前尚无关于接受治疗的癫痫患病率或发病率的数据，也没有来自未经过筛选的英国人群中癫痫女性生育力的数据。
我们利用全科医疗研究数据库确定了在英格兰和威尔士2,052,922名未经过筛选的人群中接受治疗的癫痫患者的发病率和患病率，以及特定年龄的生育率。我们将接受治疗的癫痫的期间患病率定义为1995年每10万人中正在服用抗癫痫药物的癫痫患者人数。接受治疗的癫痫的发病率定义为同一时期每10万人中新发的接受治疗的癫痫病例数。我们计算了1991年至1995年期间接受治疗的癫痫女性的生育率，并将这些生育率与1993年英格兰和威尔士的总体生育率进行了比较。
1995年接受治疗的癫痫的期间患病率为每1000人中有5.15人（95%可信区间5.05 - 5.25）。儿童中的患病率较低（5 - 9岁为3.16 [2.86 - 3.48]；10 - 14岁为4.05 [3.70 - 4.42]），而老年人中的患病率较高（65 - 69岁为6.01 [5.50 - 6.57]；70 - 74岁为6.53 [5.97 - 7.14]；75 - 79岁为7.39 [6.73 - 8.11]；80 - 84岁为7.54 [6.78 - 8.39]；85岁及以上为7.73 [6.98 - 8.66]）。接受治疗的癫痫的发病率为每10万人中有80.8人（76.9 - 84.7）。儿童中的发病率较低（5 - 9岁为63.2 [50.5 - 79.1]；10 - 14岁为53.8 [42.4 - 68.3]），而老年人中的发病率较高（65 - 69岁为85.9 [68.5 - 107.3]；70 - 74岁为82.8 [65.0 - 105.2]；75 - 79岁为114.5 [116.9 - 179.2]；80 - 84岁为159 [125.2 - 202.
