Unit of Neurology A, University Hospital of Verona, Verona, Italy.
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Epilepsia. 2018 Oct;59 Suppl 2:100-107. doi: 10.1111/epi.14496. Epub 2018 Aug 29.
To describe the demographics, etiologies, types of status epilepticus (SE), and outcomes in people with refractory and super-refractory SE from around the world, we prospectively collected cases of refractory SE (RSE) treated with continuous intravenous anesthetic drugs in an intensive care unit setting through online questionnaires using "active surveillance." We collected information about 776 cases of RSE in 50 countries over 4 years. Control of SE was achieved in 74% of the cases. Neurologic outcomes were poor in 41% of patients, and 24% died. Good outcome was associated with younger age and a history of epilepsy. Etiology strongly influenced the outcome. Patients from Asia were younger, more frequently presented with convulsive SE, and were more frequently affected by infectious etiologies when compared with patients from Europe and the Americas. Despite these differences, outcomes were similar in all countries. Demographics of patients with RSE in a global audit are similar to those in prior single center series, providing evidence of generalizability of those studies. Important differences exist among patients with RSE from different regions of the world, but these do not seem to significantly influence patient outcomes.
为了描述世界各地难治性和超难治性癫痫持续状态（RSE）患者的人口统计学、病因学、癫痫持续状态类型和结局，我们通过在线问卷使用“主动监测”前瞻性地收集了重症监护病房中使用连续静脉内麻醉药物治疗的难治性癫痫持续状态（RSE）病例。我们在 4 年内收集了来自 50 个国家的 776 例 RSE 信息。74%的病例控制了癫痫持续状态。41%的患者神经功能预后不良，24%死亡。良好的预后与年龄较小和癫痫病史有关。病因强烈影响结局。与来自欧洲和美洲的患者相比，亚洲患者年龄更小，更常出现惊厥性癫痫持续状态，更常由感染性病因引起。尽管存在这些差异，但所有国家的结局相似。全球审计中 RSE 患者的人口统计学特征与之前的单中心系列相似，为这些研究的普遍性提供了证据。来自世界不同地区的 RSE 患者存在重要差异，但这些差异似乎并未显著影响患者结局。
