Fernández-Cabrera A, Santamaría-Montero P, Álvarez-Fernández L, Teijeiro-Folgueira I, García-de Soto J, Pego-Reigosa R
Hospital Universitario Lucus Augusti, Lugo, España.
Universidad de Santiago de Compostela, Santiago de Compostela, España.
Rev Neurol. 2024 Mar 1;78(5):121-125. doi: 10.33588/rn.7805.2023324.
Epileptic seizures are a common cause of admission in emergency services at hospitals. Performing the correct diagnosis can be difficult, and deciding when and which anti-seizure medication (ASM) to prescribe is critical. Our objective is to detail the characteristics of patients treated in a medium-sized hospital for this reason.
A retrospective observational study was performed, including all the adult patients treated by the emergency service of the Lucus Augusti University Hospital between January 2022 and January 2023 with a diagnosis of epileptic seizure on discharge. The study recorded their demographic variables, history, whether it was their first seizure, the number of seizures, whether an anti-seizure medication was administered and which one, the diagnosis, the tests performed, and whether the patient was referred to the neurology service.
A total of 122 patients were diagnosed with epileptic seizures in the emergency service. 50.8% of the patients were women. The mean age was 69.8 years. Neurological assessment was requested for 47.6%. 50.8% presented their first seizure. No diagnosis was performed in 46% of the cases, of which only 10 were evaluated by the neurology service. The most common etiology was vascular. An electroencephalogram was performed on 41.8%. Levetiracetam was practically the only drug administered when the neurology department was not consulted.
Early evaluation of patients with their first seizure in the emergency service by a neurological specialist is crucial for the diagnosis of epilepsy. The same anti-seizure medication is almost always prescribed when no cross-consultation takes place.
癫痫发作是医院急诊服务中常见的入院原因。进行正确诊断可能很困难，决定何时以及开具哪种抗癫痫药物（ASM）至关重要。我们的目的是详细阐述一家中型医院中因此类原因接受治疗的患者的特征。
进行了一项回顾性观察研究，纳入了2022年1月至2023年1月期间在卢库斯·奥古斯蒂大学医院急诊科接受治疗且出院诊断为癫痫发作的所有成年患者。该研究记录了他们的人口统计学变量、病史、是否为首次发作、发作次数、是否使用了抗癫痫药物以及使用的是哪种药物、诊断结果、所做的检查，以及患者是否被转诊至神经科。
急诊科共诊断出122例癫痫发作患者。50.8%的患者为女性。平均年龄为69.8岁。47.6%的患者进行了神经学评估。50.8%的患者为首次发作。46%的病例未进行诊断，其中只有10例由神经科进行了评估。最常见的病因是血管性的。41.8%的患者进行了脑电图检查。在未咨询神经科的情况下，左乙拉西坦几乎是唯一使用的药物。
神经科专科医生在急诊服务中对首次发作患者进行早期评估对于癫痫的诊断至关重要。在没有交叉会诊的情况下，几乎总是开具相同的抗癫痫药物。
