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成人癫痫持续状态的流行病学、管理和结局:单中心意大利调查。

Epidemiology, management and outcome of status epilepticus in adults: single-center Italian survey.

机构信息

Sleep Disorders Center, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Neurology Unit, Department of General Medicine, Parma University Hospital, Parma, Italy.

出版信息

Neurol Sci. 2022 Mar;43(3):2003-2013. doi: 10.1007/s10072-021-05572-w. Epub 2021 Sep 6.

DOI:10.1007/s10072-021-05572-w
PMID:34490535
Abstract

The official variations of status epilepticus (SE) International League Against Epilepsy (ILAE, 2015) diagnostic criteria and the non-convulsive SE (NCSE) Salzburg Consensus Criteria (2013), impose the collection of updated population-based epidemiological Italian data. In this study, we aimed at evaluating (a) the frequency of SE in our hospital adopting the new ILAE 2015 SE diagnostic criteria and NCSE Salzburg Consensus Criteria, (b) the frequency of adherence to current treatment guidelines for SE and their relationship with patients' outcome, and (c) reliability of standardized prognostic scales (Status Epilepticus Severity Score-STESS-and modified STESS) for short-term outcome prediction in the setting of the newest diagnostic criteria for SE and NCSE. Detailed clinical and electrophysiological data collected in a 1-year retrospective hospital-based single-center survey on SE at Parma Hospital, Northern Italy are provided. Non-adherence to current treatment guidelines was recorded in around 50% cases, but no relation to outcome was appreciated. Mortality in our cohort increased from 30 to 50% when follow-up was extended to 30 days. STESS score was strongly correlated with short-term mortality risk (OR 18.9, 2.2-163.5, CI), and we confirm its role as easy-to-use tool for outcome evaluation also when the new ILAE diagnostic SE criteria are applied.

摘要

国际抗癫痫联盟(ILAE)2015 年发布的癫痫持续状态(SE)官方分类标准和非惊厥性 SE(NCSE)萨尔斯堡共识标准(2013 年)要求收集最新的基于人群的意大利流行病学数据。在本研究中,我们旨在评估:(a)采用新的 ILAE 2015 年 SE 诊断标准和 NCSE 萨尔斯堡共识标准后,我院 SE 的发病率;(b)SE 现行治疗指南的遵循率及其与患者预后的关系;(c)在 SE 和 NCSE 的最新诊断标准下,标准化预后量表(癫痫持续状态严重程度评分-STESS 和改良 STESS)用于短期预后预测的可靠性。提供了意大利北部帕尔马医院为期 1 年的 SE 回顾性基于医院的单中心调查中收集的详细临床和电生理数据。约 50%的病例未遵循现行治疗指南,但未观察到与预后的关系。当随访时间延长至 30 天时,我们队列中的死亡率从 30%增加到 50%。STESS 评分与短期死亡率风险密切相关(OR 18.9,2.2-163.5,CI),我们确认其作为评估预后的有用工具的作用,即使在应用新的 ILAE SE 诊断标准时也是如此。

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Seizure. 2021 Mar;86:70-76. doi: 10.1016/j.seizure.2021.01.014. Epub 2021 Jan 30.
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Neonatal seizures: When semiology points to etiology.新生儿惊厥:当症状指向病因时。
Seizure. 2020 Aug;80:161-165. doi: 10.1016/j.seizure.2020.06.025. Epub 2020 Jun 18.
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Intravenous Brivaracetam in the Treatment of Status Epilepticus: A Systematic Review.静脉注射布瓦西坦治疗癫痫持续状态的系统评价。
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Perampanel for treatment of status epilepticus in Austria, Finland, Germany, and Spain.氨己烯酸在奥地利、芬兰、德国和西班牙治疗癫痫持续状态的应用。
Acta Neurol Scand. 2019 Apr;139(4):369-376. doi: 10.1111/ane.13061. Epub 2019 Jan 20.
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Epidemiology of status epilepticus in adults: A population-based study on incidence, causes, and outcomes.成人癫痫持续状态的流行病学:一项基于人群的发病率、病因和结局研究。
Epilepsia. 2019 Jan;60(1):53-62. doi: 10.1111/epi.14607. Epub 2018 Nov 26.
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Neurol Clin Pract. 2012 Dec;2(4):275-286. doi: 10.1212/CPJ.0b013e318278be75.
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Seizure. 2018 May;58:147-153. doi: 10.1016/j.seizure.2018.04.005. Epub 2018 Apr 16.
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