Granieri E, Rosati G, Tola R, Pavoni M, Paolino E, Pinna L, Monetti V C
Epilepsia. 1983 Aug;24(4):502-14. doi: 10.1111/j.1528-1157.1983.tb04921.x.
Worldwide investigation of the epidemiology of epilepsy has suggested wide variations in the frequency of convulsive disorders. However, descriptive studies in general populations cannot be completely comparable because of a remarkable methodological dishomogeneity in definition of epilepsy, classification of seizures, and ascertainment, collection, and selection of the cases. The position with regard to the Mediterranean people was still little known, and the few studies presently available from Italy offer underestimates of epilepsy frequency owing to incompleteness in case-collection practices and lack of information about the incidence of the disease. Therefore, to verify the true frequency of epilepsy in our country, we performed a community-based epidemiologic study of convulsive disorders in the district of Copparo (population 45,153) in northern Italy. Based on 278 accepted cases with "active" epilepsy, the prevalence per 1,000 population on December 31, 1978, was 6.2 (6.4 if standardized to the Italian population). The average annual incidence for the period 1964 through 1978 was 33.1 per 100,000 (38.3 if standardized). These results, similar to those found in other Western countries, support the view that the frequency of epilepsy in Italy as a whole is higher than that indicated by the Italian studies previously published, and suggest that epilepsy is evenly distributed in Europe and the United States. Antecedents which could be considered potential causes of epilepsy were found in 39.6%, and in 39.1% of the prevalence and incidence cases, respectively; for both prevalence and incidence groups, perinatal brain injuries were the most frequent event. This high proportion of epileptic cases with underlying causes emphasizes the urgency of planning precautionary measures in Italy to improve prenatal and perinatal medical care.
全球范围内对癫痫流行病学的调查表明，惊厥性疾病的发病率存在很大差异。然而，由于在癫痫定义、发作分类以及病例的确定、收集和选择方面存在显著的方法学异质性，一般人群中的描述性研究无法完全可比。关于地中海地区人群的情况仍然知之甚少，目前来自意大利的少数研究由于病例收集方法不完整以及缺乏疾病发病率信息，低估了癫痫的发病率。因此，为了核实我国癫痫的实际发病率，我们在意大利北部科帕罗地区（人口45,153）开展了一项基于社区的惊厥性疾病流行病学研究。以278例确诊的“活动性”癫痫病例为基础，1978年12月31日每1000人口中的患病率为6.2（如果按意大利人口标准化则为6.4）。1964年至1978年期间的年平均发病率为每10万人口33.1例（标准化后为38.3例）。这些结果与其他西方国家的结果相似，支持了这样一种观点，即意大利总体上癫痫发病率高于此前意大利研究报告的数字，并表明癫痫在欧洲和美国分布均匀。在39.6%的病例中发现了可能被视为癫痫潜在病因的既往史，在患病率和发病率病例中这一比例分别为39.1%；对于患病率和发病率组，围产期脑损伤都是最常见的情况。有潜在病因的癫痫病例比例如此之高，凸显了意大利制定预防措施以改善产前和围产期医疗保健的紧迫性。
