Summary: Purpose: We wished to determine the incidence of psychogenic nonepileptic (NES) seizures in a population-based study.Methods: Cases were identified through review of the results of all long-term video-EEG studies made in Iceland during the study period.Results: The incidence of NES was 1.4 in 100,000 personyears of observation. Age-specific incidence was highest in the youngest age group (age 15-24 years) and decreased thereafter. A strong female preponderance was observed.Conclusions: The incidence of NES is equal to almost 4% of that reported for epilepsy from Iceland for persons aged 2 15 years. For people aged 15-24 years, the incidence of NES is equal to -5% of the incidence of epilepsy. Half the patients also had epilepsy. Key Words: Epidemiology-Epilepsy-Psychogenic nonepileptic seizures (NES) constitute a clinical phenomenon that resembles epileptic seizures. The diagnosis is based on recognition of typical clinical symptoms and recording of normal EEG during the episodes. The clinical diagnosis can be very difficult, and NES are frequently misdiagnosed as epileptic seizures. Long-term video-EEG monitoring (LVEM) has revolutionized the diagnosis of NES and several groups of researchers (1-6) have described the various clinical manifestations of NES. Correct diagnosis is important because inappropriate treatment for suspected epilepsy or suspected status epilepticus (SE) may be dangerous or life-threatening to the patient (7-10).The incidence of NES in a defined population is unknown, but investigators (9-1 3) have described the relative frequency of NES in selected patient groups. In Iceland, we conducted a study in which we identified all adult patients in the country first diagnosed with NES in a 5-year period.
The urgent need to treat presumptive bacterial or fungal infections in neutropenic patients has meant that initial therapy is empiric and based on the pathogens most likely to be responsible, and drug resistance. The traditional empirical treatment in Norway has been penicillin G and an aminoglycoside, and this combination has been criticized over recent y. We wished to analyse the microbiological spectrum and susceptibility patterns of pathogens causing bacteraemia in febrile neutropenic patients. This was a prospective multicentre study. During the study period of 2 y, a total of 282 episodes of fever involving 243 neutropenic patients was observed. In 34% of episodes bacteraemia was documented. Overall, 40% of the episodes were caused by Gram-positive organisms, 41% by Gram-negative organisms and 19% were polymicrobial. The most frequently isolated bacteria were Escherichia coli (25.6%), a- and non-haemolytic streptococci (15.6%), coagulase-negative staphylococci (12.4%) and Klebsiella spp. (7.4%). None of the Gram-negative isolates was resistant to gentamicin, meropenem, ceftazidime or ciprofloxacin. Only 5 coagulase-negative staphylococci isolates were resistant to both penicillin G and aminoglycoside. The overall mortality rate was 7%, and 1.2% due to confirmed bacteraemic infection.
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