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University of Texas Health Science Center at Houston, School of Public Health, Division of Epidemiology, Houston, TX; Columbia Medical School, G.H. Sergievsky Center, Departments of Epidemiology and Neurology, New York, NY; and the Mayo Clinic, Department of Medical Statistics and Epidemiology, Rochester, MN.
A population-based cohort of 714 survivors of encephalitis or meningitis between 1935 and 1981 was followed in order to evaluate the risks of unprovoked seizures after CNS infections. The 20-year risk of developing unprovoked seizures was 6.8%, and the ratio of observed to expected cases of unprovoked seizures was 6.9. The increased incidence of unprovoked seizures was highest during the first 5 years after the CNS infection but remained elevated over the next 15 years of follow-up. The type of CNS infection and the presence or absence of seizures during the acute phase of the CNS infection greatly influenced the risks of subsequent unprovoked seizures. The 20-year risk of developing unprovoked seizures was 22% for patients with viral encephalitis and early seizures, 10% for patients with viral encephalitis without early seizures, 13% for patients with bacterial meningitis and early seizures, and 2.4% for patients with bacterial meningitis without early seizures. The 20-year risk of 2.1% for patients with aseptic meningitis was not increased over the general population incidence of unprovoked seizures.
Address correspondence and reprint requests to Dr. Annegers, The University of Texas School of Public Health, P.O. Box 20186, Houston, TX 77225.
Supported in part by the Minnesota Comprehensive Epilepsy Program, Grant No. NS-16308 from the National Institute of Neurological and Communicative Disorders and Stroke.
Presented in part at the thirty-ninth annual meeting of the American Academy of Neurology, New York, NY, April 1987.
Received December 15, 1987. Accepted for publication in final form January 27, 1988.
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