Newly diagnosed single unprovoked seizures and epilepsy in Stockholm, Sweden: First report from the Stockholm Incidence Registry of Epilepsy (SIRE)

Abstract

Summary Purpose: To describe and report initial findings of a system for prospective identification and follow‐up of patients with newly diagnosed single unprovoked seizures and epilepsy in Stockholm, Sweden, the Stockholm Incidence Registry of Epilepsy (SIRE). Methods: From September 2001 through August 2004, a surveillance system has been in use to identify incident cases of first unprovoked seizures (neonatal seizures excluded) and epilepsy among residents of Northern Stockholm, an urban area with approximately 998,500 inhabitants. Potential cases are identified through multiple mechanisms: Network of health care professionals, medical record screening in specific hospital units, including outpatient clinics, emergency room services, and review of requests for electroencephalography (EEG) examination. Potential cases are classified 6 months after the index seizure based on review of medical records. Results: After screening approximately 10,500 EEG requests and 3,300 medical records, 1,015 persons met the criteria for newly diagnosed unprovoked seizures (430 single seizures; 585 epilepsy). The crude incidence for first unprovoked seizures and epilepsy was 33.9/100,000 person years, (the same adjusted to the European Standard Million), highest the first year of life (77.1/100,000) and in the elderly. No cause could be identified in 62.4%. Conclusions: We have established a sustainable system for prospective identification of new onset epilepsy cases in Stockholm. Despite a possible under‐ascertainment, the registry provides a useful starting point for follow‐up studies.

Incidence and classification of new-onset epilepsy and epilepsy syndromes in children in Olmsted County, Minnesota from 1980 to 2004: A population-based study

“…This rate is consistent with incidence of epilepsy rates of 33.3 to 82 cases per 100,000 reported in other population-based studies (Adelow et al, 2009, Blom et al, 1978, Camfield et al, 1996, Cavazzuti 1980, Christensen et al, 2007, Doose and Sitepu, 1983, Freitag et al, 2001, Hauser et al, 1993, Larsson and Eeg-Olofsson, 2006, Olafsson et al, 2005). The variation in rates among these studies may be explained by a number of features.…”

“…Some studies have included only children with two or more seizures, whereas others have included all first seizures, febrile seizures or neonatal seizures. A small number of population-based studies have reported on the incidence of new-onset epilepsy in developed countries, with the reported incidence ranging from 33.3 to 82 cases per 100,000 persons per year (Blom et al, 1978, Camfield et al, 1996, Cavazzuti, 1980, Doose and Sitepu, 1983, Freitag et al, 2001, Hauser et al, 1993, Larsson and Eeg-Olofsson, 2006, Adelow et al, 2009, Christensen et al, 2007, Olafsson et al, 2005). Incidence rates have been consistently reported as highest in the first year of life, and as slightly higher in boys than girls.…”

Valproic acid utilization among girls and women in Stockholm: Impact of regulatory restrictions

“…The incidence of diagnosed bipolar disorder in Sweden has increased over the last 20 years and was around 4–6/10,000 individuals per year in 2010, with higher numbers in women . The incidence of epilepsy is 3–5/10,000 individuals per year in Sweden . The incidence of epilepsy in the Northern countries has remained constant or declined in most age groups.…”

CYP3A5*3 and C3435T MDR1 Polymorphisms in Prognostication of Drug-Resistant Epilepsy in Children and Adolescents

“…Epilepsy is one of the most frequently occurring diseases of the nervous system in children and youth [1–3]. Despite the enormous progress made in studies concerning epilepsy, and the introduction of new antiepileptic drugs (AEDs), it still remains impossible to achieve remission of epileptic fits in some patients, due to the problem of drug resistance [4, 5].…”