Risk of epilepsy in people with adult-onset hydrocephalus: insights from the UK Biobank.

Cohort studyNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology· Jul 2026

Risk of epilepsy in people with adult-onset hydrocephalus: insights from the UK Biobank.

Jolanda Buonocore, Francesco Fortunato, Enrico Fratto … Andrea Quattrone

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Pediatric NeurosurgeryCohort studyQ2IF 2.2

Adult-onset hydrocephalus linked to markedly higher risk of new-onset epilepsy

Risk of epilepsy in people with adult-onset hydrocephalus: insights from the UK Biobank.

Jolanda Buonocore … Andrea Quattrone

Neurological sciences · Jul 2026 · Q2 in Neurology

Purpose

We aim to determine whether individuals with adult-onset hydrocephalus have an increased risk of incident epilepsy over time.

Methods

We analysed data from the UK Biobank cohort.

n = 483,790 controls

Results

hydrocephalus raises later epilepsy risk roughly 15 to 24-fold

OR 9.60 (95% CI 6.40 to 13.80)

CI excludes the null - significant

More results

Our 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).

Results were also consistent after excluding people with comorbid neurodegenerative dementias such as Alzheimer's disease.

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Conclusion · 1 of 2

We demonstrated a markedly increased risk of epilepsy in adult-onset hydrocephalus, independent of vascular and neurodegenerative comorbidities and not attributable to shunt-related complications.

Conclusion · 2 of 2

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.