Bo Zhou1, Yulan Huang2, Jinyu Wang2, Zhili Zou2, Lei Chen3, Jingmei Li3, Dong Zhou4. 1. Department of Neurology, Sichuan Provincial People's Hospital, Chengdu 610041, PR China. 2. Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu 610041, PR China. 3. Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, PR China. 4. Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, PR China. Electronic address: zhoudong6668@163.com.
Abstract
PURPOSE: To investigate the characteristics of the aetiologies of convulsive status epilepticus (CSE) in Western China and to identify the relationships of these aetiologies with the prognoses. METHODS: Consecutive registration and prospective observation of 258 cases of CSE in the Sichuan Epilepsy Center were performed from 1996 to 2010 to study the aetiology of CSE. The relationships of the aetiologies with the demographics, outcomes and complications of CSE were analysed using a logistic regression model. RESULTS: The mean age was 37.6 ± 20.21 years. The majority of the CSE (62.4%) cases were acute symptomatic cases, and the primary cause was central nervous system (CNS) infection (33.7%). Histories of epilepsy were present in 51.9% of the patients. Pre-existing epilepsy occurred due to discontinuation or reduction of antiepileptic drugs (AEDs) in 31.3% of the CSE patients. Anoxia/poisoning (p<0.05, OR 8.0, 95% CI 1.34-47.77) was an independent predictor of mortality. CNS infections (p<0.001, OR 8.99, 95% CI 3.52-22.92), cerebrovascular diseases (p =0.001, OR 6.75, 95% CI 2.11-21.61) and anoxia/poisoning (p<0.01, OR 7.64, 95% CI 1.93-30.21) were the major risk factors for complications associated with CSE. CONCLUSIONS: (1) Compared to developed countries, CNS infections seemed to be more likely to be the cause of CSE in developing countries. (2) Noncompliance with AEDs among patients with epilepsy was a prominent and avoidable trigger of CSE.
PURPOSE: To investigate the characteristics of the aetiologies of convulsive status epilepticus (CSE) in Western China and to identify the relationships of these aetiologies with the prognoses. METHODS: Consecutive registration and prospective observation of 258 cases of CSE in the Sichuan Epilepsy Center were performed from 1996 to 2010 to study the aetiology of CSE. The relationships of the aetiologies with the demographics, outcomes and complications of CSE were analysed using a logistic regression model. RESULTS: The mean age was 37.6 ± 20.21 years. The majority of the CSE (62.4%) cases were acute symptomatic cases, and the primary cause was central nervous system (CNS) infection (33.7%). Histories of epilepsy were present in 51.9% of the patients. Pre-existing epilepsy occurred due to discontinuation or reduction of antiepileptic drugs (AEDs) in 31.3% of the CSE patients. Anoxia/poisoning (p<0.05, OR 8.0, 95% CI 1.34-47.77) was an independent predictor of mortality. CNS infections (p<0.001, OR 8.99, 95% CI 3.52-22.92), cerebrovascular diseases (p =0.001, OR 6.75, 95% CI 2.11-21.61) and anoxia/poisoning (p<0.01, OR 7.64, 95% CI 1.93-30.21) were the major risk factors for complications associated with CSE. CONCLUSIONS: (1) Compared to developed countries, CNS infections seemed to be more likely to be the cause of CSE in developing countries. (2) Noncompliance with AEDs among patients with epilepsy was a prominent and avoidable trigger of CSE.