Epidemiology of status epilepticus in a rural area of northern Italy: a 2‐year population‐based study

Abstract

We performed a 2-year population-based study on status epilepticus (SE) in adults in the rural area of Lugo di Romagna, northern Italy, to verify whether an area of low-level urbanization has a lower risk of occurrence of SE (as recently suggested), different clinical features and short-term prognosis than areas of high-level urbanization. We found crude and age- and sex-adjusted annual incidence rates of SE of 16.5/100 000 and 11.6/100 000, respectively. In patients under 60 years crude incidence was 2.9/100 000 and in the elderly (>/=60 years) 38.6/100 000. Acute symptomatic SE accounted for 30% and a cerebrovascular pathology was the most frequently associated etiologic condition (60%). A history of seizures was reported in 41% of patients. The first therapeutic intervention was mainly benzodiazepines (lorazepam 46%; diazepam 33%). The 30-day case fatality was 7%. We observed that the adult population of an area with a low level of urbanization has the same risk for SE, clinical features and short-term prognosis as European urban areas. The only contrasting result is the 30-day case fatality of 7% against the 39% found in the other Italian study (Bologna), despite the similarity of the SE features in these two areas of the same region. We infer that the short-term prognosis of SE could also be considerably influenced by differences in health service organization (and hence management) possibly due to different levels of urbanization.

Risk of Status Epilepticus in Southern Europe

“…The study showed that the incidence of SE in the HD of Fe, a well-defined population in southern Europe, is 27.2/100,000/year -higher than that reported in the previous European studies, [1][2][3][4] showing that the SE risk in southern Europe is more similar to that estimated in the US. 5,6 The SE incidence in the adult population (24.0/100,000/year), as estimated in other European studies, 1,3,4 is still the highest reported in Europe.…”

“…5,6 The SE incidence in the adult population (24.0/100,000/year), as estimated in other European studies, 1,3,4 is still the highest reported in Europe. [1][2][3][4] Most of the current findings are consistent with the other European and American studies. [2][3][4][5][6] …”

Long-Term Monitoring: An Overview

“…Dunnes et al [37] estimate that NCSE constitutes 20% of all status epilepticus in adults. Recent populations-based studies have reported a higher percentage of NCSE among all status epilepticus (30% to 60%) [38][39][40][41][42]. This wide range is explained by the difference in NCSE definition, classification and probably the differences in population characteristics.…”

Review: Recent and future advances in the treatment of status epilepticus

“…Status epilepticus (SE) is one of the major neurological emergencies with an incidence of about 20/100,000 for the causasian population in industrialized countries [Chin et al 2006;Vignatelli et al 2005Vignatelli et al , 2003Knake et al 2001;Coeytaux et al 2000;Jallon et al 1999]. SE has usually been defined as a single clinical seizure lasting more than 30 min or repeated seizures over a period of more than 30 min without intervening recovery of consciousness [Knake et al 2001;DeLorenzo et al 1995; Epilepsy Foundation of America's Working Group, 1993;Hauser, 1990].…”