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秘鲁一家学术医院队列中的惊厥性癫痫持续状态

Convulsive Status Epilepticus in a Cohort of Patients from a Peruvian Academic Hospital.

作者信息

Bedoya-Sommerkamp Marcelo, Chau-Rodríguez Victor Hugo, Medina-Ranilla Jesús, Escalaya-Advíncula Alejandro, Ticse-Aguirre Ray, De La Cruz-Ramírez Walter, Burneo Jorge G

机构信息

Alberto Hurtado School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Canada.

Instituto Nacional de Ciencias Neurológicas, Lima, Perú, Canada.

出版信息

J Epilepsy Res. 2021 Jun 30;11(1):83-92. doi: 10.14581/jer.21011. eCollection 2021 Jun.

Abstract

BACKGROUND AND PURPOSE

Status epilepticus is a neurologic emergency whose epidemiology, etiology and management are scarcely known in developing countries. Our objective was to describe the demographic and clinical features as well as the management of generalized convulsive status epilepticus (GCSE) in adult patients admitted to the emergency department of an academic hospital in Peru, between March 2019 and March 2020.

METHODS

Observational study of a prospective cohort in which patients were assessed by the emergency and neurology department on the first day of hospitalization, at discharge and at 30 days post-discharge in a follow-up visit. Relevant demographics and clinical data were collected. After being encoded and sorted, univariate statistical analysis was carried out.

RESULTS

Of the sample of 59 patients, 62.7% were males, 57.6% were unemployed, 89.8% did not finish high school, and 55.9% had intermittent GCSE with no seizure at arrival. The total calculated median times were: 60 minutes from GCSE onset to hospital arrival, 110 minutes from GCSE onset to 1st line therapy, and 7 minutes from hospital arrival to 1st line therapy. The most frequently used antiepileptic drugs were one dose of benzodiazepine (41.7%), phenytoin (76.9%), and additional doses of benzodiazepines (60%) for 1st, 2nd, and 3rd line therapies, respectively. The most frequent etiologies were antiepileptic drug suspension (27.1%), undetermined (25.4%) and acute stroke (11.8%). 62.71% had 0-2 modified Rankin score at discharge.

CONCLUSIONS

In this cohort of patients, GCSE was mainly intermittent. Management times differed from the guidelines' recommendations.

摘要

背景与目的

癫痫持续状态是一种神经系统急症,在发展中国家,其流行病学、病因及治疗情况鲜为人知。我们的目的是描述2019年3月至2020年3月期间,秘鲁一家学术医院急诊科收治的成年患者中,全面性惊厥性癫痫持续状态(GCSE)的人口统计学和临床特征以及治疗情况。

方法

对一个前瞻性队列进行观察性研究,患者在住院第一天、出院时以及出院后30天的随访中,由急诊科和神经科进行评估。收集相关的人口统计学和临床数据。编码和分类后,进行单变量统计分析。

结果

在59例患者样本中,62.7%为男性,57.6%失业,89.8%未完成高中学业,55.9%为间歇性GCSE,入院时无癫痫发作。计算出的总中位时间分别为:从GCSE发作到入院60分钟,从GCSE发作到一线治疗110分钟,从入院到一线治疗7分钟。一线、二线和三线治疗最常用的抗癫痫药物分别为一剂苯二氮䓬类药物(41.7%)、苯妥英(76.9%)和额外剂量的苯二氮䓬类药物(60%)。最常见的病因是抗癫痫药物停用(27.1%)、病因不明(25.4%)和急性卒中(11.8%)。62.71%的患者出院时改良Rankin评分为0 - 2分。

结论

在这组患者中,GCSE主要为间歇性。治疗时间与指南建议不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf53/8357561/f9ab4bb008c0/jer-21011f1.jpg

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