Aziz H, Ali S M, Frances P, Khan M I, Hasan K Z
Department of Neurology, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
Epilepsia. 1994 Sep-Oct;35(5):950-8. doi: 10.1111/j.1528-1157.1994.tb02539.x.
A house-to-house, cross-sectional, population study of epilepsy on 24,130 individuals of all ages from southern Pakistan indicates an age-specific prevalence rate of 9.99 in 1,000 (14.8 in 1,000 in rural and 7.4 in 1,000 in urban areas) for recurrent, nonfebrile "active" epilepsy in Pakistan. Mean onset of epilepsy was 13.3 years, and 74.3% epileptic persons were aged < 19 years at onset of the disorder. The most common seizure type was tonicclonic in 77% [primary generalized tonic-clonic (GTC) in 59% and secondarily generalized in 18%], simple partial (SPS) in 5%, complex partial (CPS) in 6%, generalized absence in 1%, tonic in 3%, and myoclonic in 3% cases. Multiple seizures types in the same person were evident in 9.6% of only the generalized group. A putative cause could be suggested in 38.4% of cases: 32% had a positive family history of epilepsy, most common among siblings. Common perceived precipitants included fever in 29.2% and emotional disturbances in 16.6%. Only 3% of epileptic persons believed that their illness was due to super-natural causes. Treatment status was very poor, with only 2% rural and 27% urban epileptic persons receiving antiepileptic drugs (AEDs) at the time of the survey. We discuss the logistic and management problems of population-based epidemiologic studies in developing countries.
一项针对巴基斯坦南部24130名各年龄段人群的逐户横断面癫痫患病率研究表明，巴基斯坦复发性、非热性“活动性”癫痫的年龄特异性患病率为千分之9.99（农村地区为千分之14.8，城市地区为千分之7.4）。癫痫的平均发病年龄为13.3岁，74.3%的癫痫患者在疾病发作时年龄小于19岁。最常见的发作类型为强直阵挛发作，占77%[原发性全身性强直阵挛发作（GTC）占59%，继发性全身性发作占18%]，简单部分性发作（SPS）占5%，复杂部分性发作（CPS）占6%，全身性失神发作占1%，强直性发作占3%，肌阵挛发作占3%。仅在全身性发作组中，9.6%的患者存在同一人有多种发作类型的情况。38.4%的病例可推测出可能的病因：32%有癫痫家族史阳性，最常见于兄弟姐妹之间。常见的诱发因素包括29.2%的患者有发热，16.6%的患者有情绪障碍。只有3%的癫痫患者认为他们的疾病是由超自然原因引起的。治疗状况非常差，在调查时，只有2%的农村癫痫患者和27%的城市癫痫患者正在接受抗癫痫药物（AEDs）治疗。我们讨论了发展中国家基于人群的流行病学研究中的后勤和管理问题。
