Patients with epilepsy are at an increased risk of subsequent stroke: a population-based cohort study

Seizure. 2014 May;23(5):377-81. doi: 10.1016/j.seizure.2014.02.007. Epub 2014 Feb 22.


Purpose: Epilepsy is well known as a disorder in poststroke patients. However, studies that have investigated the association between epilepsy and the risk of subsequent stroke are limited. This population-based study investigated the incidence and risk of stroke in patients with epilepsy by using the Taiwan National Health Insurance claims data.

Methods: We identified 3812 patients newly diagnosed with epilepsy in 2000-2008 and 15,248 nonepilepsy comparisons frequency matched according to sex, age, and index year. We searched for subsequent stroke diagnoses in both cohorts until the end of 2009. The incidence rates and hazard ratios of stroke were estimated based on sex, age, the average defined daily doses (DDDs) of antiepilepsy drugs, and comorbidity.

Results: The stroke incidence of the epilepsy cohort was 3-fold higher than that of the comparison cohort. The age-specific results indicated that in the epilepsy cohort and the comparison cohort, the risk was the highest for the youngest group (20-39 years).

Conclusion: The patients with epilepsy exhibited a higher incidence of cerebral stroke than the general population did. In addition, younger patients with epilepsy and patients who took a high doses of antiepileptic drugs exhibited a high risk of stroke.

Keywords: Comorbidity; Epilepsy; Insurance claims data; Retrospective cohort study; Stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticonvulsants / therapeutic use
  • Cohort Studies
  • Comorbidity
  • Epilepsy / drug therapy
  • Epilepsy / epidemiology*
  • Epilepsy / etiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk
  • Stroke / complications
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Taiwan / epidemiology
  • Young Adult


  • Anticonvulsants