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Summary:Purpose: To investigate the risk of illnesses in a cohort of patients with epilepsy and in matched nonepilepsy controls, by type and complications.Methods: A total of 951 children and adults with idiopathic, cryptogenic, or remote symptomatic epilepsy and 904 matched controls seen in secondary and tertiary centers in eight European countries (England, Estonia, Germany, Italy, the Netherlands, Portugal, Russia, Slovenia) were followed prospectively for 17,484 and 17,206 person-months and asked to report any spontaneous complaint requiring medical attention (illness), its type and complications (hospitalization, absence from work or school, medical action). Risk assessment was done by actuarial methods, relative risks (RR), and 95% confidence intervals (CIs).Results: During the study period 644 patients (68%) and 504 controls (56%) reported an illness (p < 0.0001); 30% were seizure related. The cumulative probability of illness at 12 and 24 months was 49 and 86% in the cases and 39 and 75% in the controls (p < 0.0001). The largest differences regarded disorders affecting the nervous system (NS) (RR, 3.3; 95% CI, 2.3-4.2) and ear, nose, and throat (ENT) (RR, 1.3; 95% CI, 1.0-1.6). In patients with epilepsy, an NS illness was more likely to be followed by hospital admission, work absence, or medical intervention. All risks were significantly reduced after excluding seizure-related events.Conclusions: Patients with epilepsy are at higher risk of NS and ENT illnesses and complications than the general population. However, the risk of illness is significantly reduced when seizure-related events are excluded. Key Words: EpilepsyMorbidity-Illnesses.Patients with epilepsy have been thought to have a higher risk of illness than the general population, but comorbidity in epilepsy has been investigated in few population-based prevalence or analytic studies. Other clinical conditions and disabilities were reported by 47% of adults with epilepsy in Sweden, with psychiatric, cardiovascular, pulmonary, systemic, and renal diseases in decreasing order (1). Lifetime mental and gastric disorders were reported by 7 and 3% of adults with childhoodonset epilepsy in the Czech Republic (2). In Finland, somatic comorbidity was found in 84-95% of patients with childhood-onset epilepsy and 67-74% of controls (3). In a multicenter European cohort study of children and adults with idiopathic, cryptogenic, or remote symptomatic epilepsy, we found one or more illnesses at entry in 30% of cases compared with 17% of age-and sex-matched controls (4).These contrasting results may be explained by differences in the study populations and in the study design and methods. In addition, the morbidity risk attributable Accepted September 14, 2003. Address correspondence and reprint requests to Dr. E. Beghi at Istituto di Ricerche Farmacologiche "Mario Negri," Via Eritrea 62, 20157 Milano, Italy. E-mail: beghi@marionegri.it to the disease cannot be explored in studies on the prevalence of other clinical conditions in epilepsy. For these reasons, i...

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Цель исследования-определение переносимости и эффективности постоянной стимуляции блуждающего нерва (vagus nerve stimulation-VNS) у больных фармакорезистентной эпилепсией (ФРЭ). Пациенты и методы. 9 больным ФРЭ в возрасте от 14 до 38 лет была осуществлена имплантация системы VNS. Длительность катамнеза составила 8-12 мес. Результаты исследования. В первые 2-3 мес после установки стимулятора у половины больных наблюдалось сокращение частоты припадков более чем на 50%, у остальных пациентов такой же положительный эффект был достигнут через 8-12 мес посредством коррекции параметров VNS. У всех больных отмечено снижение частоты, продолжительности и тяжести припадков, укорочение постприпадочного периода. Побочные эффекты в виде дисфонии и першения в горле наблюдались у 12,5% пациентов. Эти нежелательные явления регрессировали при изменении параметров магнитной стимуляции. Положительная динамика по данным электроэнцефалографии в виде уменьшения пароксизмальных эпилептиформных нарушений отмечена в 62,5% наблюдений. Выводы. VNS-терапия является безопасным и эффективным дополнительным методом лечения ФРЭ, позволяющим уменьшить частоту и тяжесть эпилептических припадков.