To determine the prevalence of major neurologic disorders, a door-to-door survey was conducted in six cities of the People's Republic of China during 1983 in a well-defined population of 63,195. The survey included a complete census and a screening interview together with an examination having high sensitivity for detecting individuals with frequently occurring neurologic disorders, including epilepsy. All individuals with responses or findings suggesting neurologic disease were examined by senior neurologists using standardized diagnostic criteria. There was 100% cooperation among the study subjects. Two hundred eighty-nine individuals alive on prevalence day (January 1, 1983) were identified as having epilepsy, yielding a lifetime age-adjusted (to the 1960 U.S. population) point prevalence ratio of 4.4/1,000. There were 16 people who developed epilepsy in the sample population during 1982, providing an age-adjusted incidence rate of 35/100,000 per year. The most frequent type identified was generalized convulsive seizures. Brain injury, intracranial infection, and cerebrovascular disease, in that order, were the leading putative causes of epilepsy.
A door-to-door survey was carried out in six cities of the People's Republic of China (PRC). There was 100% cooperation with the survey. Among 63,195 screened individuals, there were 392 prevalent cases of completed stroke and 115 incidence cases. Prevalence ratios and incidence rates for completed stroke showed a south-to-north gradient. The highest point prevalence ratio and incidence rate (age-adjusted to the 1960 US population) were documented in Harbin in northeast PRC (1,249/100,000; 441/100,000/yr). The majority of new completed strokes were cerebral infarction, but the percentage of intracerebral hemorrhage (44%) was much greater than that reported among Caucasian populations.
and yyySEIN -Epilepsy Institute in the Netherlands Foundation, Heemstede, The Netherlands SUMMARY Purpose: Detailed data on the mortality of epilepsy are still lacking from resource-poor settings. We conducted a long-term follow-up survey in a cohort of people with convulsive epilepsy in rural areas of China. In this longitudinal prospective study we investigated the causes of death and premature mortality risk among people with epilepsy. Methods: We attempted to trace all 2,455 people who had previously participated in a pragmatic assessment of epilepsy management at the primary health level. Putative causes of death were recorded for those who died, according to the International Classification of Diseases. We estimated proportional mortality ratios (PMRs) for each cause, and standardized mortality ratios (SMRs) for each age-group and cause. Survival analysis was used to detect risk factors associated with increased mortality.Key Findings: During 6.1 years of follow-up there were 206 reported deaths among the 1,986 people with epilepsy who were located. The highest PMRs were for cerebrovascular disease (15%), drowning (14%), self-inflicted injury (13%), and status epilepticus (6%), with probable sudden unexpected death in epilepsy (SUDEP) in 1%. The risk of premature death was 2.9 times greater in people with epilepsy than in the general population. A much higher risk (SMRs 28-37) was found in young people. Duration of epilepsy and living in a waterside area were independent predictors for drowning. Significance: Drowning and status epilepticus were important, possibly preventable, causes of death. Predictors of increasing mortality suggest interventions with efficient treatment and education to prevent premature mortality among people with epilepsy in resource-poor settings.
SYNOPSIS The first large scale study of migraine epidemiology from a nationwide collaborative group was carried out in 22 Chinese rural and ethnic minority communities of 21 provinces of the People's Republic of China during 1985 in a well‐defined population of 246,812 inhabitants. On the day for which prevalence was calculated, January 1, 1985, there were 1703 cases of migraine, yielding a point prevalence ratio of 690/100,000. The prevalence ratio of migraine for females was higher than that for males. The overall sex difference in the prevalence ratio was significant (Z=26.57, P<0.0001), The prevalence began from the age before 10 years old, and monotonically increased until it had reached its peak at age 40–49, then decreased steadily. The geographic distribution of the prevalence has the tendency that the south is higher than the north, and the west is higher than the east. The incidence rate of new cases was 37/100,000 in 1984. The incidence rate reached its peak at age 15–19, then gradually decreased. Incidence before age 10 and after age 50 was rare. The incidence rate of migraine was higher in females than in males. Sex difference in the incidence rate was significant (Z=4.35, P<.0001}. Clinical Manifestations: In 804 cases with auras, 793 (46.56%) had visual disturbances, 11 (0.64°/o) had hemiparesis or hemiparesthesia. Concomitant nausea or vomiting occurred in 1,349 cases (79.21%). Among those 1703 cases with headache, 584 cases (34.29%) were unilateral, 791 cases (40.45%) were bilateral and 328 cases (19.26%) were uncertain. In duration of headache, 744 cases (43.69%) had less then 24 hours and 720 cases (42.28%) had 24 hours or longer. In the frequency of episodes, 818 cases (48.03%) had no more than once per month and 742 cases (43.57%) had more than once per month. Classification: There were 752 cases (44.16%) of prodromal type (classical) migraine, 929 cases (54.55%) of non‐prodromal type (common) migraine, 14 cases (0,82%) of cluster headache, 2 cases (0.12%} of hemiplegic migraine. Each of vertebrobasilar and ophthalmoplegic types had 3 cases (0.18%), Trigger Factors for Episodes: 678 cases (39.81%) were triggered by mental stress (tension, anxiety etc.), 509 cases (29.81%) by change of weather and 293 cases (20.88%) of females by menstruation.
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