Mac Tu Luong, Tran Duc-Si, Quet Fabrice, Odermatt Peter, Preux Pierre-Marie, Tan Chong Tin
Institute of Neurological Epidemiology and Tropical Neurology, Limoges, France.
Lancet Neurol. 2007 Jun;6(6):533-43. doi: 10.1016/S1474-4422(07)70127-8.
Epilepsy is a significant, but often underappreciated, health problem in Asia. Here, we systematically review the literature on epidemiology, aetiology, and management of epilepsy in 23 Asian countries. Prevalence estimates are available for only 11 countries from door-to-door surveys and are generally low. Figures for annual incidence in China and India are similar to those in the USA and Europe but lower than those reported from Africa and Latin America. There is a peak in incidence and prevalence in childhood, but a second peak in elderly people, as seen in developed countries, has not been documented. The main causes are head injuries, cerebrovascular disease, CNS infections, and birth trauma. Availability of epilepsy care depends largely on economic factors. Imaging and neurophysiological facilities are available in most countries, but often only in urban centres. Costly drugs, a large treatment gap, limited epilepsy surgery, and negative public attitude to epilepsy are other notable features of management in Asia. An understanding of the psychosocial, cultural, economic, organisational, and political factors influencing epilepsy causation, management, and outcome should be of high priority for future investigations.
癫痫在亚洲是一个严重但常被低估的健康问题。在此，我们系统回顾了23个亚洲国家关于癫痫流行病学、病因学及治疗的文献。仅11个国家有挨家挨户调查得出的患病率估计值，且普遍较低。中国和印度的年发病率数据与美国和欧洲相似，但低于非洲和拉丁美洲报告的数据。发病率和患病率在儿童期有一个高峰，但与发达国家一样，老年人群中的第二个高峰尚未得到证实。主要病因是头部损伤、脑血管疾病、中枢神经系统感染和产伤。癫痫治疗的可及性很大程度上取决于经济因素。大多数国家都有影像和神经生理学设施，但通常仅在城市中心才有。昂贵的药物、巨大的治疗差距、有限的癫痫手术以及公众对癫痫的负面态度是亚洲治疗方面的其他显著特征。了解影响癫痫病因、治疗及预后的社会心理、文化、经济、组织和政治因素应成为未来研究的高度优先事项。
