The incidence and lifetime prevalence of neurological disorders in a prospective
community-based study in the UK
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Medline Identifier??
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97176643 ??
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Authors
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MacDonald BK. Cockerell OC. Sander JW. Shorvon SD.
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Institution
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Institute of Neurology and National Hospital for Neurology and Neurosurgery,
Queen Square, London WC1N 5BG, UK.
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Title
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The incidence and lifetime prevalence of neurological disorders in a prospective
community-based study in the UK
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Comments
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Comment in: Brain. 2000 Apr;123 ( Pt 4):663-4; PMID: 10733997
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Local Messages
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Held at BMA Library
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Source
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Brain. 123 ( Pt 4):665-76, 2000 Apr.
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Abstract
Over an 18-month period, all incident cases of neurological disorders were ascertained
prospectively in an unselected urban population based in 13 general practices
in the London area by a General Practice Linkage Scheme with the National Hospital
for Neurology and Neurosurgery. In three of these practices, the lifetime prevalence
of neurological disorders was also assessed. A population of 100 230 patients
registered with participating general practices was followed prospectively for
the onset of neurological disorders. Multiple methods of case finding were used
to maintain accuracy. The age- and sex-adjusted incidence rates of neurological
disorders were calculated. The lifetime prevalence of neurological disorders was
surveyed in 27 658 of the patients. The age- and sex-adjusted incidence rates
were calculated for major neurological conditions. [These are expressed as rates
per 100 000 persons per annum, with 95% confidence intervals (CI) in parentheses].
The commonest of these were first cerebrovascular events, 205 (CI: 183,
230); shingles, 140 (CI: 104, 184); diabetic polyneuropathy, 54 (CI:
33, 83); compressive neuropathies, 49 (CI: 39, 61); epilepsy, 46 (CI:
36, 60); Parkinson's disease, 19 (CI: 12, 27); peripheral neuropathies,
15 (CI: 9, 23); CNS infections, 12 (CI: 5, 13); post-herpetic neuralgia,
11 (CI: 6, 17); and major neurological injuries, 10 (CI: 4, 11).
Lifetime prevalence rates are also reported (expressed as rate per 1000 persons
with 95% CI). The most prevalent conditions were: completed stroke, 9 (CI:
8, 11); transient ischaemic attacks, 5 (CI: 4, 6); active epilepsy, 4 (CI:
4, 5); congenital neurological deficit, 3 (CI: 3, 4); Parkinson's disease,
2 (CI: 1, 3); multiple sclerosis, 2 (CI: 2, 3); diabetic polyneuropathy,
2 (CI: 1, 3); compressive mononeuropathies, 2 (CI: 2, 3); and sub-arachnoid
haemorrhage, 1 (CI: 0.8, 2). Overall, the onset of 625 neurological disorders
was observed per 100 000 population annually. Six percent of the population had
at some time had a neurological disorder. This is the first study of the incidence
and lifetime prevalence of neurological disorders in recent times; we found that
these disorders give rise to significant morbidity in the community.
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