Parkinson disease and the risk of epileptic seizures

Journal: Annals of Neurology

Authors: Katharina Gruntz ¹, Marlene Bloechliger ¹, Claudia Becker ¹, Susan S Jick ^2 3, Peter Fuhr ⁴, Christoph R Meier ^1 2 5, Stephan Rüegg ⁴

NLM Citation: Gruntz K, Bloechliger M, Becker C, Jick SS, Fuhr P, Meier CR, Rüegg S. Parkinson disease and the risk of epileptic seizures. Ann Neurol. 2018 Feb;83(2):363-374. doi: 10.1002/ana.25157. Epub 2018 Feb 10. PMID: 29369409.

Abstract

Objective: To assess the association between incident Parkinson disease (PD) and subsequent incident epileptic seizures.

Methods: We conducted a retrospective cohort study with a nested case-control analysis using data from the U.K. Clinical Practice Research Datalink. We identified patients aged ≥40 years with an incident diagnosis of PD between 1995 and 2016 and a matched comparison group of PD-free individuals. We calculated crude incidence rates (IRs) with 95% confidence intervals (CIs) of epileptic seizures in PD patients and the PD-free comparison group, and corresponding crude incidence rate ratios (IRRs). In the nested case-control analysis, we calculated adjusted odds ratios (adj. ORs) of incident PD among cases with incident epileptic seizures and seizure-free controls overall and stratified by various seizure-provoking comorbidities.

Results: Among 23,086 incident PD patients and 92,343 PD-free individuals, we identified 898 patients with incident epileptic seizures. The crude IR of epileptic seizures in PD patients was 266.7/100,000 person-years (95% CI = 235.6-297.7), and in PD-free individuals it was 112.4/100,000 person-years (95% CI = 103.5-121.3; IRR = 2.37, 95% CI = 2.06-2.73). The adj. OR of epileptic seizures was 1.68 (95% CI = 1.43-1.98) in PD patients compared with PD-free individuals. PD patients with comorbid brain disorders (adj. OR = 12.36, 95% CI = 8.74-17.48) or with > 1 seizure-provoking comorbidity (adj. OR = 13.24, 95% CI = 10.15-17.25) were at the highest risk of epileptic seizures compared with PD-free individuals with no seizure-provoking comorbidities.

Interpretation: This study suggests that incident PD is associated with an increased risk of incident epileptic seizures. Ann Neurol 2018;83:363-374.

© 2018 American Neurological Association.