Syvertsen Marte, Nakken Karl Otto, Edland Astrid, Hansen Gunnar, Hellum Morten Kristoffer, Koht Jeanette
Department of Neurology, Drammen Hospital, Drammen, Norway.
National Center for Epilepsy, Oslo University Hospital, Oslo, Norway.
Epilepsia. 2015 May;56(5):699-706. doi: 10.1111/epi.12972. Epub 2015 Mar 25.
Epilepsy represents a substantial personal and social burden worldwide. When addressing the multifaceted issues of epilepsy care, updated epidemiologic studies using recent guidelines are essential. The aim of this study was to find the prevalence and causes of epilepsy in a representative Norwegian county, implementing the new guidelines and terminology suggested by the International League Against Epilepsy (ILAE).
Included in the study were all patients from Buskerud County in Norway with a diagnosis of epilepsy at Drammen Hospital and the National Center for Epilepsy at Oslo University Hospital. The study period was 1999-2014. Patients with active epilepsy were identified through a systematic review of medical records, containing information about case history, electroencephalography (EEG), cerebral magnetic resonance imaging (MRI), genetic tests, blood samples, treatment, and other investigations. Epilepsies were classified according to the revised terminology suggested by the ILAE in 2010.
In a population of 272,228 inhabitants, 1,771 persons had active epilepsy. Point prevalence on January 1, 2014 was 0.65%. Of the subjects registered with a diagnostic code of epilepsy, 20% did not fulfill the ILAE criteria of the diagnosis. Epilepsy etiology was structural-metabolic in 43%, genetic/presumed genetic in 20%, and unknown in 32%. Due to lack of information, etiology could not be determined in 4%.
Epilepsy is a common disorder, affecting 0.65% of the subjects in this cohort. Every fifth subject registered with a diagnosis of epilepsy was misdiagnosed. In those with a reliable epilepsy diagnosis, every third patient had an unknown etiology. Future advances in genetic research will probably lead to an increased identification of genetic and hopefully treatable causes of epilepsy.
癫痫在全球范围内给个人和社会带来了沉重负担。在应对癫痫护理的多方面问题时，采用最新指南进行的流行病学研究至关重要。本研究的目的是在挪威一个具有代表性的郡中，采用国际抗癫痫联盟（ILAE）建议的新指南和术语，找出癫痫的患病率及病因。
纳入研究的是挪威布斯克吕德郡在德拉门医院和奥斯陆大学医院国家癫痫中心被诊断为癫痫的所有患者。研究时间段为1999年至2014年。通过系统查阅病历确定活动性癫痫患者，病历包含病史、脑电图（EEG）、脑磁共振成像（MRI）、基因检测、血液样本、治疗及其他检查信息。癫痫根据ILAE 2010年建议的修订术语进行分类。
在272,228名居民中，有1,771人患有活动性癫痫。2014年1月1日的点患病率为0.65%。在登记有癫痫诊断代码的受试者中，20%不符合ILAE的诊断标准。癫痫病因中，结构性代谢性占43%，遗传性/推测为遗传性占20%，不明原因占32%。由于信息缺乏，4%的病因无法确定。
癫痫是一种常见疾病，在该队列中影响了0.65%的受试者。每五名登记有癫痫诊断的受试者中就有一名被误诊。在那些有可靠癫痫诊断的患者中，每三名患者就有一名病因不明。基因研究的未来进展可能会增加对癫痫遗传病因的识别，有望找到可治疗的病因。
