秘鲁某学术医院一组患者的惊厥性癫痫持续状态

Journal of epilepsy research Pub Date : 2021-06-30 eCollection Date: 2021-06-01 DOI:10.14581/jer.21011
Marcelo Bedoya-Sommerkamp, Victor Hugo Chau-Rodríguez, Jesús Medina-Ranilla, Alejandro Escalaya-Advíncula, Ray Ticse-Aguirre, Walter De La Cruz-Ramírez, Jorge G Burneo
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引用次数: 1

摘要

背景和目的:癫痫持续状态是一种神经系统紧急情况,其流行病学、病因和治疗在发展中国家尚不清楚。我们的目的是描述秘鲁一家学术医院急诊科收治的成年患者的人口学和临床特征以及全身性痉挛性癫痫持续状态(GCSE)的处理,方法:前瞻性队列的观察性研究,其中患者在住院第一天、出院时和出院后30天由急诊和神经科进行随访评估。收集相关的人口统计和临床数据。编码和排序后,进行单变量统计分析。结果:在59名患者的样本中,62.7%为男性,57.6%为失业者,89.8%未完成高中学业,55.9%为间歇性普通中等教育证书,抵达时没有癫痫发作。计算出的总中位时间为:从普通中等教育证书发病到住院60分钟,从普通中等学校证书发病到一线治疗110分钟,从住院到一线治疗7分钟。最常用的抗癫痫药物是一剂苯二氮卓类药物(41.7%)、苯妥英(76.9%)和额外剂量的苯二氮卓类药物(60%),分别用于一线、二线和三线治疗。最常见的病因是抗癫痫药物混悬液(27.1%)、不明原因(25.4%)和急性中风(11.8%)。62.71%的患者出院时Rankin评分为0-2。结论:在这组患者中,GCSE主要是间歇性的。管理时间与指导方针的建议不同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Convulsive Status Epilepticus in a Cohort of Patients from a Peruvian Academic Hospital.

Background and purpose: Status epilepticus is a neurologic emergency whose epidemiology, etiology and management are scarcely known in developing countries. Our objective was to describe the demographic and clinical features as well as the management of generalized convulsive status epilepticus (GCSE) in adult patients admitted to the emergency department of an academic hospital in Peru, between March 2019 and March 2020.

Methods: Observational study of a prospective cohort in which patients were assessed by the emergency and neurology department on the first day of hospitalization, at discharge and at 30 days post-discharge in a follow-up visit. Relevant demographics and clinical data were collected. After being encoded and sorted, univariate statistical analysis was carried out.

Results: Of the sample of 59 patients, 62.7% were males, 57.6% were unemployed, 89.8% did not finish high school, and 55.9% had intermittent GCSE with no seizure at arrival. The total calculated median times were: 60 minutes from GCSE onset to hospital arrival, 110 minutes from GCSE onset to 1st line therapy, and 7 minutes from hospital arrival to 1st line therapy. The most frequently used antiepileptic drugs were one dose of benzodiazepine (41.7%), phenytoin (76.9%), and additional doses of benzodiazepines (60%) for 1st, 2nd, and 3rd line therapies, respectively. The most frequent etiologies were antiepileptic drug suspension (27.1%), undetermined (25.4%) and acute stroke (11.8%). 62.71% had 0-2 modified Rankin score at discharge.

Conclusions: In this cohort of patients, GCSE was mainly intermittent. Management times differed from the guidelines' recommendations.

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