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Abstract
Objectives: Celiac disease (CD) is associated with several neurologic disorders but it is unclear whether CD is associated with epilepsy. We therefore investigated whether biopsy-verified CD is associated with epilepsy.
Methods: Cohort study. Using biopsy report data from all Swedish pathology departments (n = 28), we identified individuals with CD who were diagnosed from 1969 to 2008 (Marsh 3: villous atrophy). Through Cox regression, we calculated hazard ratios (HRs) for epilepsy (defined as a diagnosis of epilepsy in the Swedish National Patient Register) in 28,885 individuals with CD and 143,166 controls matched for age, sex, calendar period, and county.
Results: Individuals with CD were at an increased risk of future epilepsy (HR = 1.42; 95% confidence interval [CI] = 1.24–1.62) (272 individuals with CD had a diagnosis of epilepsy vs an expected 192). The absolute risk of future epilepsy in patients with CD was 92/100,000 person-years (excess risk = 27/100,000 person-years). This risk increase was seen in all ages, including children with CD. The HR for having at least 2 interactions with health care due to epilepsy was 1.41 (95% CI = 1.19–1.66). When we restricted epilepsy to those with both a diagnosis of epilepsy and an independent record of antiepileptic drug prescriptions, CD was associated with a 1.43-fold increased risk of epilepsy (95% CI = 1.10–1.86).
Conclusion: Individuals with CD seem to be at a moderately increased risk of epilepsy.
GLOSSARY
- CD=
- celiac disease;
- CI=
- confidence interval;
- HR=
- hazard ratio;
- ICD=
- International Classification of Diseases;
- OR=
- odds ratio;
- VA=
- villous atrophy
Footnotes
-
Study funding: J.F.L. was supported by grants from The Swedish Society of Medicine, the Swedish Research Council–Medicine (522–2A09–195), the Sven Jerring Foundation, the Örebro Society of Medicine, the Karolinska Institutet, Örebro University Hospital, the Clas Groschinsky Foundation, the Juhlin Foundation, the Majblomman Foundation, Uppsala-Örebro Regional Research Council, and the Swedish Celiac Society. A.E. was funded by the Stockholm County Council (A.L.F.). T.T. was funded by the Stockholm County Council (A.L.F.).
Supplemental data at www.neurology.org
- Received August 19, 2011.
- Accepted November 28, 2011.
- Copyright © 2012 by AAN Enterprises, Inc.
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