Navarro-Pérez M P, Viloria-Alebesque A, Garcés-Antón E, Marín-Gracia M, García-Noain J A, Santos-Lasaosa S, Mauri-Llerda J A
Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, España.
Instituto de Investigación Sanitaria Aragón, Zaragoza, España.
Rev Neurol. 2021 Jun 16;72(12):419-425. doi: 10.33588/rn.7212.2020590.
To analyse the care of patients with epilepsy (PwE) who visit the hospital emergency department (ED) due to an epileptic seizure.
Single-centre retrospective observational study, based on the clinical history of the PwE seen in the ED for epileptic seizures between January 2016 and December 2018. Demographic, clinical and ED management variables were collected. Specifically, the results of a computed tomography (CT) brain scan and electroencephalogram and the presence of precipitating factors for epileptic seizures were analysed.
A total of 232 PwE were identified, with a mean age of 49.8 years. The most frequent reason for the visit was focal epileptic seizures (50.4%). In 106 cases (45.6%) possible precipitating factors were found, of which poor therapy adherence was the most frequent. An urgent CT brain scan was performed in 67 cases (28.9%) and acute alterations were found in only one patient. An electroencephalogram was carried out in 16 of them (6.9%). Adjustments were made to the antiepileptic treatment in 135 patients (58.1%). A total of 195 were discharged without being hospitalised (84.1%).
PwE accounted for a considerable proportion of the patients seen for epileptic seizures in the ED. The presence of a potentially controllable precipitating factor was identified in almost half of the cases, the most frequent being poor adherence to therapy. In addition, a high number of urgent complementary tests were performed, which in many cases may be unnecessary and avoidable.
分析因癫痫发作前往医院急诊科（ED）就诊的癫痫患者（PwE）的护理情况。
单中心回顾性观察研究，基于2016年1月至2018年12月期间在急诊科因癫痫发作就诊的PwE的临床病史。收集人口统计学、临床和急诊科管理变量。具体分析了脑部计算机断层扫描（CT）和脑电图结果以及癫痫发作的诱发因素。
共识别出232例PwE，平均年龄49.8岁。就诊的最常见原因是局灶性癫痫发作（50.4%）。在106例（45.6%）病例中发现了可能的诱发因素，其中治疗依从性差最为常见。67例（28.9%）患者进行了紧急脑部CT扫描，仅1例患者发现急性病变。其中16例（6.9%）进行了脑电图检查。135例患者（58.1%）的抗癫痫治疗进行了调整。共有195例（84.1%）未住院即出院。
PwE在急诊科因癫痫发作就诊的患者中占相当比例。几乎一半的病例中发现存在潜在可控的诱发因素，最常见的是治疗依从性差。此外，进行了大量紧急辅助检查，在许多情况下这些检查可能是不必要且可避免的。
