Infections and risk of epilepsy in children and young adults: A nationwide study

Abstract

Summary Objective The development of epilepsy has been linked to infections of the central nervous system, but recently also to infections and inflammation outside of the central nervous system. Thus we investigated the association between infections and the risk of subsequent epilepsy. Methods This was a Danish nationwide population‐based cohort study comprising a total of 1 938 555 individuals born between 1982 and 2012. Individuals were followed from birth until December 31, 2012, death, disappearance, emigration, or epilepsy diagnosis, whichever came first (28 512 666 person‐years of follow‐up). The exposure was hospital contacts for infection and the outcome was a diagnosis of epilepsy as recorded in the Danish National Hospital Register. Hazard ratios were calculated using Cox proportional hazards models adjusted for age, sex, calendar period, Apgar score, gestational age, birth weight, and parental history of epilepsy. Results A total of 25 825 individuals received an epilepsy diagnosis during the study period, among whom 8235 (32%) had a previous hospital contact for infection. A hospital contact for infection was associated with a 78% increase in the risk of subsequently receiving an epilepsy diagnosis (hazard ratio 1.78, 95% confidence interval [CI] 1.73‐1.83) compared with those without infection. The highest risk was observed after central nervous system infections (hazard ratio 4.97, 95% CI 4.42‐5.59), but increased risks were identified across all infected organ systems and types of pathogens. The risk of receiving an epilepsy diagnosis was correlated with the temporal proximity of the infection (P < 0.001) and increased with the number of hospital contacts for infection (P < 0.001) and with the severity of infection (P < 0.001). Significance The risk of receiving an epilepsy diagnosis was increased after a wide range of infections, suggesting that systemic inflammatory processes may be involved in the development of epilepsy.

Epilepsy diagnosis after Covid-19: A population-wide study

“…Also, it is important to stress the short-term nature of the data available. The risk of epilepsy is highest soon after brain lesions, but a slightly elevated risk persists for extended periods of time after CNS infections or trauma [ 12 , [14] , [15] , [16] ]. Similar long-term effects of Covid are not yet possible to investigate.…”

Gut Microbiome Distinguishes Patients With Epilepsy From Healthy Individuals

“…In addition, the small sample size may also have a certain impact, and more trials are necessary. Exogenous factors can affect intestinal microbiome to increase seizures, such as diet, infection (Ahlers et al, 2019) and antibiotic use (Nørgaard et al, 2012), among which carbapenems (Cannon et al, 2014), imipenem, and meropenem (Owens, 2008;Leibovitch and Jacobson, 2015) are all highly associated with seizures. Although we excluded people with infections and those using probiotics and antibiotics when selecting subjects, there was no guarantee of diet or environmental effects.…”

Application of Machine Learning Methods for Epilepsy Risk Ranking in Patients with Hematopoietic Malignancies Using

“…The results of a study of the risk of epilepsy in young patients and children show that systemic inflammation, a reflection of which may be the fact of increased platelets, may play a significant role. This role can be both direct and mediated through the development of complications involving the CNS) in the development of epilepsy [ 53 ]. Given the heterogeneity of causes leading to the development of elevated neutrophil levels, unambiguous interpretation is difficult and the role of systemic inflammation in the development of epilepsy requires further study.…”