Skinner Holly J, Dubon-Murcia Sofia A, Thompson Arnold R, Medina Marco T, Edwards Jonathan C, Nicholas Joyce S, Holden Kenton R
Department of Neurosciences, Division of Neurology, Medical University of South Carolina, 96 Jonathan Lucas Ave. Suite 307 Clinical Science Bldg., Charleston, SC 29425, USA.
Seizure. 2010 Jul;19(6):363-7. doi: 10.1016/j.seizure.2010.05.007. Epub 2010 Jun 15.
Epidemiologic data on convulsive status epilepticus (CSE) is needed to develop preventative strategies. Epilepsy is one of the known risk factors for CSE. A systematic review of epidemiologic studies on status epilepticus (SE) completed in the United States and Europe reports that people with epilepsy account for less than 50% of cases of SE in all age groups. Less is known about the epidemiology of SE in developing countries including those in Central America. A high incidence of epilepsy, widespread non-adherence to anti-epileptic drugs (AED), and common use of complementary and alternative medicines have been shown in all ages in the developing country of Honduras, Central America. In 2003, an epidemiologic study of CSE in Honduran children demonstrated it is common and exhibits a long duration until onset of treatment. The etiologies, treatment, and outcomes of CSE in Honduran adults have not been thoroughly studied. This study is a consecutive case series of 31 adult patients presenting with CSE to the adult medicine emergency department of the tertiary care "Hospital Escuela" in the capital city Tegucigalpa, Honduras. The majority (77.4%) of patients had a prior history of epilepsy. Non-adherence to AED was the most common etiology of CSE (75.0%). The mortality rate in this pilot CSE study was 14.8%, which is similar to studies from industrialized countries where mortality from status epilepticus ranged from 7.6 to 22% for all age groups. However, this rate is concerning given that CSE from epilepsy and AED non-adherence generally carries a good prognosis. Improving AED adherence in this population appears to be the most effective approach in decreasing the rate, and possibly the mortality of Honduran adult CSE.
需要惊厥性癫痫持续状态（CSE）的流行病学数据来制定预防策略。癫痫是已知的CSE风险因素之一。一项对美国和欧洲完成的癫痫持续状态（SE）流行病学研究的系统评价报告称，在所有年龄组中，癫痫患者占SE病例的比例不到50%。对于包括中美洲国家在内的发展中国家的SE流行病学了解较少。在中美洲的发展中国家洪都拉斯，所有年龄段都显示出癫痫发病率高、普遍不坚持服用抗癫痫药物（AED）以及普遍使用补充和替代药物的情况。2003年，一项对洪都拉斯儿童CSE的流行病学研究表明，CSE很常见，且在开始治疗前持续时间较长。洪都拉斯成年人CSE的病因、治疗和结局尚未得到充分研究。本研究是对31例在洪都拉斯特古西加尔巴首都的三级医疗“埃斯库埃拉医院”成人内科急诊科就诊的CSE成年患者的连续病例系列研究。大多数（77.4%）患者有癫痫病史。不坚持服用AED是CSE最常见的病因（75.0%）。在这项CSE试点研究中的死亡率为14.8%，这与工业化国家的研究相似，在工业化国家，所有年龄组的癫痫持续状态死亡率在7.6%至22%之间。然而，鉴于癫痫和不坚持服用AED导致的CSE通常预后良好，这一死亡率令人担忧。提高该人群对AED的依从性似乎是降低洪都拉斯成年CSE发病率以及可能降低死亡率的最有效方法。
