Beghi Ettore, Cornaggia Cesare
Centro Regionale per l'Epilessia e Clinica Neurologica, Università di Milano-bicocca, Monza, Italy.
Epilepsia. 2002 Sep;43(9):1076-83. doi: 10.1046/j.1528-1157.2002.18701.x.
To assess the risk of illnesses and accidents in patients with epilepsy and to evaluate the proportion of those risks attributable to epilepsy.
Nine hundred fifty-one referral patients with idiopathic, cryptogenic, or remote symptomatic epilepsy and 909 matched controls (relatives or friends) were followed up prospectively for 1-2 years in eight European countries (Italy, Germany, Holland, England, Portugal, Russia, Estonia, and Slovenia). Each patient and control received a diary to keep notes regarding any illness or accident. Patients with epilepsy specifically recorded relations with seizures.
Six hundred forty-four patients recorded 2,491 illnesses compared with 1,665 illnesses in 508 controls. The cumulative probability of illness in patients was 49% by 12 months and 86% by 24 months (controls, 39 and 75%; p < 0.0001). One hundred ninety-nine patients and 124 controls had 270 and 140 accidents, respectively. The cumulative probability of accident in the cases was 17 and 27% by 12 and 24 months (controls, 12 and 17%; p < 0.0001). The chance of two or more illnesses or accidents was modestly but significantly greater in the patients. Illnesses and accidents were mostly trivial. Thirty percent of illnesses and 24% of accidents were seizure related. When illnesses and accidents related to seizures were excluded, the chance of illnesses and accidents was fairly similar in the two groups.
Patients with idiopathic, cryptogenic, or remote symptomatic epilepsy have a moderately higher risk of illnesses and accidents than do the general population. With few exceptions, the events are trivial. When seizure-related events are excluded, patients with epilepsy are not at any significantly higher risk of illnesses and accidents.
评估癫痫患者患病及发生事故的风险，并评估这些风险中可归因于癫痫的比例。
在八个欧洲国家（意大利、德国、荷兰、英国、葡萄牙、俄罗斯、爱沙尼亚和斯洛文尼亚）对951例特发性、隐源性或远隔症状性癫痫转诊患者及909例匹配对照（亲属或朋友）进行了为期1至2年的前瞻性随访。每位患者和对照者都收到一本日记，用于记录任何疾病或事故情况。癫痫患者特别记录了与癫痫发作的关系。
644例患者记录了2491种疾病，而508例对照记录了1665种疾病。患者患病的累积概率在12个月时为49%，24个月时为86%（对照分别为39%和75%；p<0.0001）。199例患者和124例对照分别发生了270次和140次事故。病例组事故的累积概率在12个月和24个月时分别为17%和27%（对照组分别为12%和17%；p<0.0001）。患者发生两种或更多种疾病或事故的可能性略高，但具有显著差异。疾病和事故大多不严重。30%的疾病和24%的事故与癫痫发作有关。排除与癫痫发作相关的疾病和事故后，两组中患病和发生事故的可能性相当相似。
特发性、隐源性或远隔症状性癫痫患者患病及发生事故的风险略高于普通人群。除少数例外情况外，这些事件并不严重。排除与癫痫发作相关的事件后，癫痫患者患病及发生事故的风险并无显著升高。
