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Abstract
Objective To describe risk and risk factors of epilepsy after hospitalization for brain infection in adults in Sweden.
Methods This was a matched retrospective cohort study based on the comprehensive National Patient and Cause of Death Registers. All individuals age >18 without prior epilepsy who received inpatient care in 2000–2010 for a brain infection were included, with 3 age- and sex-matched unexposed controls per exposed individual (n = 12,101 exposed and 36,228 controls). Kaplan-Meier risks of epilepsy after different brain infections were calculated and risk factors identified by Cox regression. Patients were followed until the end of 2017.
Results The 10-year risk of epilepsy was 5.9% (95% confidence interval [CI] 5.5–6.3) in cases and 1.2% (95% CI 1.0–1.4) in controls: 1.7% (95% CI 0.7–2.7) after tick-borne encephalitis, 4.1% (95% CI 3.3–4.9) after bacterial meningitis, 26.0% (95% CI 21.5–30.5) after herpes simplex virus encephalitis, and 30.2% (95% CI 27.1–33.3) after brain abscess. In Cox regression, seizure during the index admission and mechanical ventilation were epilepsy risk factors.
Conclusions Epilepsy is common after several types of brain infections in adults. The type of infection, its severity, and propensity to cause seizures in the acute phase influence the risk of subsequent epilepsy.
Classification of evidence This study provides Class II evidence that in adults, brain infection is associated with an increased risk of subsequent epilepsy.
Glossary
- CI=
- confidence interval;
- HR=
- hazard ratio;
- HSE=
- herpes simplex virus encephalitis;
- KM=
- Kaplan-Meier;
- ICD=
- International Classification of Disease;
- ILAE=
- International League Against Epilepsy;
- NPR=
- National Patient Register;
- TBE=
- tick-borne encephalitis
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Class of Evidence: NPub.org/coe
- Received March 30, 2020.
- Accepted in final form August 3, 2020.
- © 2020 American Academy of Neurology
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