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Background: Sardinia, insular Italy, represents a particular epidemiological setting to investigate polyfactorial diseases, by virtue of its phylogeny and geographic isolation over time and of a well-established network of health operators and information systems. We present the first prevalence study of epilepsy conducted on a large Sardinian population by means of multiple source ascertainment. Methods: Cases were ascertained in the province of Sassari (population of 333,576) for the period between January 1, 2000 and December 31, 2008 based on records from (a) the District Center for Epilepsy, (b) the District Health Information System Unit, and (c) the neurologists practicing within the National Health System. Results: The total crude prevalence of active epilepsy on December 31, 2007 was 6.62 per 1,000 (95% CI 5.3-7.9), 6.51 in men (95% CI 5.4-7.6), and 6.73 in women (95% CI 5.7-7.7). The highest prevalence (8.78 per 1,000) was estimated in the elderly (≥65 years). 50.5% were symptomatic epilepsies. Of these, over 50% were secondary to cerebrovascular disorders in the elderly. Conclusions: The epidemiological behavior of prevalence of active epilepsy in Sardinia appears to be in line with that of other developed countries, despite the role that population-specific genetic and environmental factors exert in modulating the risk for other neurological diseases. The action of (exogenous) factors commonly distributed in western populations, also influencing, at least partially, the epidemiological patterns of epilepsy in Sardinians, should not be ruled out. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: In diseases with unpredictably long latent period, such as multiple sclerosis (MS), cluster studies, and the analysis of disease distribution by gender and age of onset, can provide clues to disease etiopathogenesis. Sardinia, insular Italy, is among the regions at highest risk for MS worldwide. Multiple epidemiological evidences favour the role of exogenous factors in modulating MS incidence in Sardinians. Its steady increase over time is the main determinant for the observed increased prevalence of MS. Incidence is especially increasing for MS with RR initial course, in individuals with older age and in the female population. More women that will develop MS are believed to being born now. Early childhood is likely the age of susceptibility to MS, and especially in women, in most recent cases, and in individuals developing MS at earlier age and with RR initial clinical course. These evidences suggest that specific exogenous (gender-related? perinatal?) factors have recently been exerting as determinants of the MS increase in Sardinians and the change of its phenotype. Such factors are unlikely agents with fixed latency incubation period, but they could rather be the result of recent lifestyle changes and/or of their interplay with a highly susceptible genetic background. [Copyright &y& Elsevier]