Devender Bhalla1, Achille Edem Tchalla2, Claude Mignard3, Benoît Marin1, Didier Mignard4, Pierre Jallon5, Pierre-Marie Preux6. 1. INSERM U1094, Tropical Neuroepidemiology, Limoges, France; University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, GEIST, Limoges, France; CHU, Limoges, France. 2. INSERM U1094, Tropical Neuroepidemiology, Limoges, France; University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, GEIST, Limoges, France; CHU, Limoges, France; Université de Limoges; IFR 145 GEIST; EA 6310 HAVAE (Handicap Activité Vieillissement Autonomie et Environnement), Limoges F-87025, France. 3. Département de Neurologie, Groupe Hospitalier Sud Réunion, Saint-Pierre, Reunion. 4. Université de Limoges; IFR 145 GEIST; EA 6310 HAVAE (Handicap Activité Vieillissement Autonomie et Environnement), Limoges F-87025, France. 5. Thezan des Corbières, F-11200, 20 route de Narbonne, France. 6. INSERM U1094, Tropical Neuroepidemiology, Limoges, France; University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, GEIST, Limoges, France; CHU, Limoges, France. Electronic address: preux@unilim.fr.
Abstract
PURPOSE: We aimed to determine the incidence and case-fatality of first-ever status epilepticus (SE) among the general population living in La Reunion Island, a French overseas territory in the Indian Ocean near Madagascar. METHODS: We recruited cases (1st July 2004-30th June 2005) in a population-based manner using neurology, neurosurgery, electroencephalogram, emergency, paediatric and neuroradiology services; emergency medical aid service; emergency and admission service of private and public clinics; neurologists (public and private); private paediatricians and practitioners of various rural hospitals. All cases had an electroencephalogram (EEG) and were assessed by an epileptologist. Standard definition and classification schemes were used. Those with known epilepsy were not part of this analysis. RESULTS: Sixty-five cases (males: n=41, 63.1%) had epileptologist-confirmed SE, with 38.5% (n=25) being >60 years of age. Global incidence rate was 8.52/100 000 (95% confidence interval 6.5-10.5). A bimodal age distribution with high frequency and incidence among young (<10 years age) (frequency: 12.3%; incidence 6.6/100,000) and aged (>60 years) (frequency: 40.0%; incidence 35.0/100,000) was observed. We found that 60%, 32.3%, 6.7% had convulsive, partial and non-convulsive SE respectively (1% remained unclassified). Of the cases identified, 44.6%, 38.5%, 16.9% had unprovoked, provoked or cryptogenic seizures respectively. The most important aetiological factors identified included: stroke (27.7%), alcoholism/toxicity (18.5%), cryptogenic (16.9%), infections (10.8%). Mortality was 18.5%. CONCLUSION: The incidence of SE incidence in La Reunion Island was lower than that described elsewhere. The status type was found to be dependent on aetiology and age. The study confirms that SE is more frequent in men and in older adults and is associated with significant short-term case mortality.
PURPOSE: We aimed to determine the incidence and case-fatality of first-ever status epilepticus (SE) among the general population living in La Reunion Island, a French overseas territory in the Indian Ocean near Madagascar. METHODS: We recruited cases (1st July 2004-30th June 2005) in a population-based manner using neurology, neurosurgery, electroencephalogram, emergency, paediatric and neuroradiology services; emergency medical aid service; emergency and admission service of private and public clinics; neurologists (public and private); private paediatricians and practitioners of various rural hospitals. All cases had an electroencephalogram (EEG) and were assessed by an epileptologist. Standard definition and classification schemes were used. Those with known epilepsy were not part of this analysis. RESULTS: Sixty-five cases (males: n=41, 63.1%) had epileptologist-confirmed SE, with 38.5% (n=25) being >60 years of age. Global incidence rate was 8.52/100 000 (95% confidence interval 6.5-10.5). A bimodal age distribution with high frequency and incidence among young (<10 years age) (frequency: 12.3%; incidence 6.6/100,000) and aged (>60 years) (frequency: 40.0%; incidence 35.0/100,000) was observed. We found that 60%, 32.3%, 6.7% had convulsive, partial and non-convulsive SE respectively (1% remained unclassified). Of the cases identified, 44.6%, 38.5%, 16.9% had unprovoked, provoked or cryptogenic seizures respectively. The most important aetiological factors identified included: stroke (27.7%), alcoholism/toxicity (18.5%), cryptogenic (16.9%), infections (10.8%). Mortality was 18.5%. CONCLUSION: The incidence of SE incidence in La Reunion Island was lower than that described elsewhere. The status type was found to be dependent on aetiology and age. The study confirms that SE is more frequent in men and in older adults and is associated with significant short-term case mortality.