A prospective study of smoking, caffeine, and alcohol as risk factors for seizures or epilepsy in young adult women: Data from the Nurses’ Health Study II

Abstract

SUMMARY Purpose Seizures and epilepsy are associated with significant disability and substantial treatment costs, yet little is known about primary prevention. We prospectively examined the association of cigarette smoking, caffeine use, and alcohol intake with risk of seizure or epilepsy among women, aged 25-42 years, in the Nurses’ Health Study II. Methods Participants provided dietary and cigarette smoking information on multiple questionnaires beginning in 1989. Among 116,363 women at-risk for incident seizure or epilepsy, we confirmed 95 cases of seizure and 151 cases of epilepsy occurring from 1989 to 2005 using information from a detailed supplementary questionnaire and medical records. Multivariable-adjusted relative risks (RR) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression. Results Compared with never smoking, current cigarette smoking was associated with an increased risk of seizure (RR 2.60, 95% CI 1.53-4.42), after adjustment for stroke and other potential confounding factors. Past smoking was not associated with risk of seizure, but was associated with modestly increased risk of epilepsy (RR 1.46, 95% CI 1.01-2.12). Long-term caffeine and moderate alcohol intake were not associated with seizure or epilepsy. Discussion Cigarette smoking may be associated with increased risk of seizure. More prospective studies are needed to investigate potential factors to ultimately prevent the development of seizures or epilepsy.

Key Findings on Alcohol Consumption and a Variety of Health Outcomes From the Nurses’ Health Study

“…For example, long-term moderate alcohol intake was not associated with seizure or epilepsy. 38 We also found that moderate alcohol consumption had no substantial adverse effect on renal function in women over an 11-year follow-up period. 39 In a cross-sectional study of alcoholic intake and early lens changes, alcohol consumption, especially liquor and wine, was positively related to nuclear opacity, and wine consumption was associated with a lower odds of cortical opacity.…”

Young adult ischaemic stroke related acute symptomatic and late seizures: risk factors

“…A similar effect of tobacco use has only been described in autosomal dominant nocturnal frontal lobe epilepsy . Contrary to our findings, current smoking was associated with a 2.6‐fold risk for seizure occurrence in 25–42‐year‐old female nurses . However, the inverse association found in our study may reflect a withdrawal effect of chronic nicotine stimulation during treatment of acute ischaemic stroke.…”

Female reproductive factors and risk of seizure or epilepsy: Data from the Nurses’ Health Study II

“…To identify incident cases, we mailed participants who self‐reported new seizure/epilepsy diagnoses after 1989 a validated seizure supplementary questionnaire (Dworetzky et al., 2009) and requested permission to access medical records. The questionnaire assessed detailed information regarding the age at first seizure, the number of lifetime seizures, family history, medication history, etiology provided by physician, seizure description (i.e., limb jerks, warnings, alteration in awareness), and diagnostic procedures [magnetic resonance imaging (MRI), computed tomography (CT), electroencephalography (EEG), video‐EEG, and neurologic consultation].…”