abstract details

The summaries are free for public use. ARTHROS will continue to add and archive summaries of articles deemed relevant to ARTHROS by our Faculty.

Epilepsy among Systemic Lupus Erythematosus Patients: Insights from a Large Database Analysis

Author information

Watad A1,2,3, Tiosano S1,3, Bragazzi NL4, Brigo F5, Comaneshter D6, Cohen AD6,7, Amital H1,2,3. Neuroepidemiology. 2017 Dec 1;50(1-2):1-6. doi: 10.1159/000485136. [Epub ahead of print]

Abstract

Author information

1 Department of Medicine "B", Tel-Hashomer, Israel.

2 The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.

3 Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

4 School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.

5 Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy, Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.

6 Chief Physician's Office, Clalit Health Services Tel Aviv, Faculty of Health Sciences, Tel Aviv, Israel.

7 Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.

Abstract

OBJECTIVE: Epilepsy is characterized by a relevant epidemiological and clinical burden. In the extant literature, an increased risk of seizures has been described in several inflammatory/autoimmune disorders, including systemic lupus erythematosus (SLE). However, so far, relatively few and small size-based studies have been conducted. We aimed to investigate the link between seizure and SLE utilizing a large sample of subjects and extensive data analysis.

METHODS: Patients with SLE were compared with age- and sex-matched controls regarding the prevalence of epilepsy in a cross-sectional study. Chi-square and t tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services.

RESULTS: The study included 5,018 patients with SLE and 25,090 age- and gender-frequency-matched controls. The proportion of epilepsy was found significantly higher among SLE patients (4.03 vs. 0.87%, p < 0.001). Using logistic regression, adjusting for multiple confounding factors, older age (≥70 years) resulted as negative predictor (OR 0.42 [95% CI 0.27-0.62], p <0.001), whereas the presence of SLE was a positive predictor of epilepsy (OR 4.70 [95% CI 3.94-5.82], p < 0.001). Interaction between SLE and elderly age resulted in high OR of 5.47 for epilepsy (95% CI 2.53-11.9).

CONCLUSION: Our study confirms the higher prevalence of epilepsy in SLE patients. Physicians should be aware of such findings and have a lower threshold for suspecting epileptic seizures in these patients. Further studies are needed to better elucidate the mechanisms by which SLE favors the insurgence of seizures.