Elsevier

Epilepsy Research

Volume 71, Issues 2–3, October 2006, Pages 206-215
Epilepsy Research

Temporal changes in the incidence of epilepsy in Finland: Nationwide study

https://doi.org/10.1016/j.eplepsyres.2006.06.017Get rights and content

Abstract

Purpose

To examine possible changes over time in the incidence of epilepsy in different age groups.

Methods

Based on the nationwide full-refundable antiepileptic drug register and population register, incidence of newly diagnosed epilepsy was measured by granted full-refundable antiepileptic drugs for epilepsy.

Results

The incidence was throughout all age groups higher in men than in women. The incidence in the total population had significantly declined in 1986–2002, from 71.6/100,000 to 52.9/100,000. The incidence significantly decreased in children (0.77; 0.71–0.84, p < 0.0001) and adults (0.83; 0.77–0.89, p < 0.0001) but increased in the elderly (1.18; 1.10–1.26, p < 0.0001). The increased incidence in the elderly over the time period was primarily seen in women.

Conclusion

The incidence of epilepsy has significantly declined in both children and adults with a concurrent increase in the incidence among the elderly. Further studies are needed to elucidate the precise cause of these temporal changes.

Section snippets

Methods

This study was based on the register data of the whole Finnish population (population approximately 5.2 million in 2002) from 1986 to 2002. Since 1967, three years after the National sickness insurance scheme came into force, a register has been kept on patients granted full-refundable antiepileptic drugs. The right for this special refund is based on clinical diagnosis and a statement given on a semi-structured form by a trained adult or pediatric neurologist. In Finland, the density of

Results

Table 1 exhibits the incidence rates of epilepsy by year, age group and gender in the Finnish population. During the observation period 1986–2002, there was a significant overall decrease in the annual incidence of epilepsy in the population from 71.6/100,000 in 1986 to 52.9/100,000 in 2002 (RR = 0.86; 95% CI 0.81–0.92, p < 0.0001). The decreased incidence occurred in both men (0.84; 0.79–0.90, p = 0.0001) and women (0.89; 0.83–0.90, p = 0.0004). Although the overall incidence decreased, there were

Discussion

The present study confirms the now well established observation that the incidence of epilepsy is highest in the very young and very old (Brodie and Kwan, 2005, Hauser et al., 1993, Loiseau et al., 1990, Olafsson et al., 1996). The detailed analysis, made possible by the national registry of Finland, shows that there are secular trends in the incidence of epilepsy and that these differ by age and gender. Weaknesses of the present study are its retrospective approach and register-based data. Its

Conclusions

Over the past two decades there has been a steady decline in the incidence of epilepsy in children, adolescents and adults. However, there has been a gradual rise in the incidence of epilepsy in the elderly, particularly in women. It is hoped that increased recognition and treatment of potential risk factors such as hypertension and stroke will eventually reverse this trend.

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