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Original Investigation
April 2016

Efforts in Epilepsy Prevention in the Last 40 YearsLessons From a Large Nationwide Study

Author Affiliations
  • 1Departments of Public Health and Child Neurology, University of Turku, Turku, Finland
  • 2National Institute of Health and Welfare, Helsinki, Finland
  • 3Epilepsy Research Group, Berlin, Germany
JAMA Neurol. 2016;73(4):390-395. doi:10.1001/jamaneurol.2015.4515

Importance  Prevention of new-onset epilepsy is an important public health issue and presents a pressing unmet need. It is unclear whether progress has been made in preventing new-onset epilepsy.

Objective  To determine whether progress has been made in the prevention of epilepsy in Finland during the last 40 years.

Design, Setting, and Participants  Using a long-term national register study of 5.04 million Finnish individuals, we looked at first-time inpatient admissions in Finland for a diagnosis of epilepsy from 1973 to 2013. Patients with epilepsy were defined by the occurrence of 2 or more unprovoked seizures. This study was conducted on July 29, 2015.

Main Outcomes and Measures  In Finland, patients with epilepsy are routinely hospitalized at time of diagnosis, thus providing evidence for the incidence of epilepsy.

Results  Of the mean 5.04 million Finnish individuals followed up for the development of epilepsy from 1973 to 2013, 100 792 people were identified as having epilepsy. Of these, 46 995 (47%) had focal epilepsy. The mean age for those included in the study was 45 years for men (interquartile range, 24-65 years) and 46 years for women (interquartile range, 23-71 years). We found no change in the incidence of epilepsy in the age range of those younger than 65 years (60 per 100 000 in 1973 and 64 per 100 000 in 2013). However, there was a significant increase in epilepsy among those older than 65 years (from 57 per 100 000 to 217 per 100 000).

Conclusions and Relevance  We found no evidence that progress has been made in preventing new-onset epilepsy in those younger than 65 years in the last 40 years; in fact, there was a nearly 5-fold rise of new-onset epilepsy among the elderly population.