ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026
Risk of epilepsy in people with adult-onset hydrocephalus: insights from the UK Biobank.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimWe aim to determine whether individuals with adult-onset hydrocephalus have an increased risk of incident epilepsy over time.
methodsWe analysed data from the UK Biobank cohort. Diagnoses of "hydrocephalus" and "epilepsy" were identified through ICD-10-coded health records, excluding congenital and secondary cases. The association between these two diseases was investigated using logistic regression (adjusted for age and sex); subsequently, we performed a sampled cohort study to evaluate the hazard ratio (HR) for incident epilepsy in people with adult-onset hydrocephalus using Cox proportional hazards models with a dedicated sensitivity analysis including different sets of covariates such as demographic, lifestyle, vascular, and genetic factors.
resultsOur cohort included 483,790 controls, 5,028 individuals with epilepsy, and 320 with adult-onset hydrocephalus. Hydrocephalus and epilepsy were strongly associated (OR: 9.6, 95% CI: 6.4-13.8, p < 0.001). Adjusted Cox models demonstrated a markedly increased risk of incident epilepsy in people with adult-onset hydrocephalus, with HR values ranging from 14.62 (95% CI: 7.91-27.00, p < 0.001) to 23.80 (95% CI: 12.87-44.03, p < 0.001) across models, after adjusting for multiple covariates. Results were also consistent after excluding people with comorbid neurodegenerative dementias such as Alzheimer's disease.
conclusionsWe demonstrated a markedly increased risk of epilepsy in adult-onset hydrocephalus, independent of vascular and neurodegenerative comorbidities and not attributable to shunt-related complications. These findings underscore the importance of increased diagnostic vigilance, as seizures may be under-recognized in this population, and support further research to clarify mechanisms and optimize management strategies.
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