WHO/IEM/ILAE全球抗癫痫运动-宁夏农村癫痫的流行病学调查

目的：调查宁夏农村癫痫病人的患病率、发病率和治疗缺口。方法：利用统一的调查表，采用随机整群抽样的方法．对宁夏吴忠市利通区杨马湖乡逐家逐户进行癫痫流行病学问卷调查。结果：共调查11630人，确诊癫痫病人99人，癫痫病患病率8．51‰，发病率25．8／100000人。从未接受治疗的病人数45人，占45．5％，不正规治疗的病人数22人，占22．2％，正规治疗的病人数32人，占32．3％，1周内接受过西药治疗的人数19人，占19.2％。结论：宁夏农村地区癫痫病患病率较高，治疗缺口较大。     

河南焦作市武陟县农村人群癫痫流行病学调查

目的：调查了解我国农村地区癫痫的患病率及治疗缺口，为开展防治工作提供依据。方法：河南省焦作市武陟县作为调查点，采用随机整群抽样方法确定调查人群，由经过统一培训的医生入户调查。调查人数为12457人。凡初筛调查时确诊或可疑的癫痫患者，均经神经科医生再次访查确诊。结果：调查确诊59例癫痫患者，患病率为4．7‰。活动性癫痫患病率为3．5‰，年发病率32．1／10万人口。全部患者中有25．4％未治疗，47．5％患者治疗不正规。活动性癫痫的治疗缺口为32．5％。结论：本次调查农村地区癫痫患病率与以往报道接近，约有2／3患者没有得到正确治疗，应尽快制订合理的干预对策。     

青岛市山区脑血管病流行病学调查

为了解沿海城区脑血管流行病学情况，我们连续３年对所辖区域２０，０００人群进行了脑血管病患病率、发病率和死亡率的死亡率的调查，并对４０岁及４０岁以上人口高血病患病率进行了调查。结果脑血管病患病率：４６５．５／１０万人，４２９．３／１０万人，年均率４６４．３／１０万人；发病率；１４８．８／１０万人，１６２．２／１０万人和１８５／１０万人，平均率１６５．１／１０万人；死亡率：８６．４／１０万人，９０。６     

癫痫手术治疗的评价和病人的选择

癫痫手术治疗的评价和病人的选择谭启富根据流行病学调查，我国癫痫患病率为０．４４％，推算病人约为５００万以上；癫痫发病率为３５／１０万，与大多数欧洲国家的报道相似。约３／４的癫痫病人用抗癫痫药物治疗可控制发作或减少发作，预后良好。但仍有１／４的病人用药...     

103例成人继发性癫痫与病因分析

目的 探讨成人继发性癫痫的病因。方法 回顾性分析我院近10年来住院诊断的103例成人继发性癫痫的临床资料。结果 继发性癫痫的病因依次为脑血管病(61／103)、脑炎脑膜炎(13／103)、颅内肿瘤(11／103)、代谢性疾病(5／103)、酗酒性肝硬化(5／103)、脑囊虫(2／103)、脑动静脉血管畸形(2／103)、放射性脑病(2／103)和中毒(2／103)。全身性强直-阵挛发作占56．31％，简单部分性发作占26．21％，复杂部分性发作占17．48％，癫痫持续状态11例。本组继发性癫痫的各类型卒中，脑血栓形成最多(占50．82％)；其次为脑出血(占19．67％)：蛛网膜下腔出血(占11．48％)；脑栓塞(占11．48％)；腔隙性脑梗死最少(占6．55％)。结论 脑血管病是成人继发性癫痫的最主要病因，正确地诊断继发性癫痫的病因和发作类型有助于及时正确的治疗。     

首次癫痫样发作的治疗

癫痫的患病率为0．5％左右，大约3．5％的人一生中出现过一次癫痫样发作。换一个角度说，约有3％的人一次发作后没有第二次或更多的发作，其他0．5％的人首次发作后以不固定的间隔反复发作，成为典型的癫痫患者。目前还没有准确的预测方法判断首次发作后就诊的患者今后是否会复发，这就出现了首次发作后是否需要治疗的问题。     

保定市重性抑郁障碍流行病学调查

目的：了解保定市重性抑郁障碍的患病率、人口学特征和社会生活功能状况。方法：采用多阶段分层整群抽样方法随机抽取≥18岁的人群10073人，以一般键康问卷12项（GHQ-12）为筛选工具，以美国精神障碍诊断与统计手册第4版（DSM-Ⅳ）轴Ⅰ障碍定式临床检查病人版（SCID-I／P）为调查诊断工具。用功能大体评定量表（GAF）评价功能状况。结果：重性抑郁障碍的终生患病率为4．19％（95％CI：3．78％～4．60％）；时点患病率为2．64％（95％CI：2．31％～2．97％）。时点患病率女性3．26％明显高于男性2．00％（u=3．73，P〈0．01）；农村2．84％明显高于城市1．40％（u=2．76，P〈0．01）；50～69岁年龄段患病率较高；单次发作60．80％，复发39．20％；GAF平均为（50．74±6．73）分，社会和生活功能受损明显。结论：重性抑郁障碍的患病率相对较高，严重影响患者的社会生活功能。     

青岛市北区脑血管病流行病学调查

为了解沿海城区脑血管病流行病学情况，我们连续３年对所辖区域２０，０００人群进行了脑血管病患病率、发病率和死亡率的调查，并对４０岁及４０岁以上人口高血压病患病率进行了调查。结果脑血管病患病率：４６５．５／１０万人（１９８９），４２９．３／１０万人（１９９０）和４９８．１／１０万人（１９９１），年均率４６４．３／１０万人；发病率：１４８．８／１０万人（１９８９），１６２．２／１０万人（１９９０）和１８５／１０万人（１９９１），年均率１６５．１／１０万人；死亡率：８６．４／１０万人（１９８９），９０．６／１０万人（１９９０）和９０．１／１０万人（１９９１），年均率８９／１０万人。高血压患病率１０．１‰，标化率８．４９‰。对脑血管病的致病危险因素进行了探讨。     

卒中继发癫(癎)的临床分析

目的探讨卒中继发癫痫的发生率、发作临床特点（发生时间、发作形式与病灶部位的关系）、发病机制、治疗措施等有关问题。方法选择经头CT或MRI确诊的急性卒中患者共564例．随访1～2年观察所有病人癫病发生率、发作临床特点．探讨继发性癫痫发病机制，总结治疗措施。结果本组病人继发癫病者66例，癫痫发生率11．7％（66／564）。其中脑血栓形成发生率为10．2％（30／294）．脑栓塞为12．7％（14／110），脑出血为12．9％（16／124）．蛛网模下腔出血16．6％（6／36）；69．7％的继发癫痫发生在脑血管病发病的2周内；出血性卒中多表现大发作，缺血性卒中多表现为部分性发作；治疗上以抗癫痫药物为主，大多数患者不需长期服药。结论卒中继发癫痫的发生率为11．7％．以蛛网模下腔出血最易发生，出血性卒中多表现为全面性发作，缺血性卒中多表现部分性发作．其中早发性癫痫（2周内发作）占69．7％，抗癫痫药物有效．一般不需长期服药。     

原发全身性癫痫遗传流行病学研究

本文报道１００例原发全身性癫痫家系的遗传流行病学研究结果。先证者一级亲属患病率为６．８６％，二级亲属为１．０３％；分别是对照组一级亲属的１３．８３倍和２．０８倍。原发全身性癫痫的遗传度为：一级亲属０．７５２１±０．０６７８，二级亲属０．３５９２±０．０７４６；加权平均０．５７４３±０．０５０２。说明遗传因素起重要作用。发病年龄影响因素分析表明：原发全身性癫痫有一定年龄依从性。ＥＥＧ家系分析显示，该型癫痫一级亲属癫痫样放电明显高于对照组一级亲属，提示癫痫样放电的遗传倾向。     

A longitudinal study of epilepsy in Kolkata, India

Purpose: This study aimed to determine the prevalence, incidence, and mortality rates of epilepsy in the city of Kolkata, India. This is the first such longitudinal study in a heterogeneous urban Indian population. Methods: A two‐stage door‐to‐door survey of a stratified random sample was undertaken within the municipal limits of Kolkata. Trained field workers detected and interviewed the cases using a simple screening questionnaire, and the detailed follow‐up was done by neurologists. The survey was conducted annually for five consecutive years from March 2003 through February 2008. Results: A total of 52,377 (52.74% men) individuals were screened. There were 309 prevalent and 66 incident cases of active epilepsy. The prevalence and average annual incidence rate (AAIR) with 95% confidence interval (CI), age‐standardized to World Standard Population, were 572.8 (509.79–641.54) per 100,000 and 27.27 (21.03–34.80) per 100,000 per year, respectively. The age‐specific incidence rates of epilepsy showed bimodal distribution. During the 5‐year period, 20 cases of active epilepsy died. The average annual mortality rate (AAMR) was 7.63 (95% CI 4.45–11.26) per 100,000 population per year. Compared to the general population of Kolkata, the all‐cause standardized mortality ratio (SMR) for persons with epilepsy was 2.58 overall (men 3.67; women 1.77). There was no significant difference between slum and nonslum dwellers in epidemiologic parameters. Conclusions: The AAIR of epilepsy is comparable to that observed in developed countries, but AAMR is higher. The all‐cause SMR for epilepsy relative to the general population is, however, similar to that of developed nations.     

Cysticercosis and epilepsy in the city of Tone, north of Togo

An epidemiology study was conducted in Tone, a city in the very north of Togo from November 1 to 25, 1995. The prevalence of epilepsy was studied in 9,155 subjects and seroprevalence of cysticercosis in 1,343. This was a representative sample of this region with 194,000 inhabitants. The prevalence of epilepsy was 18.6 per 1 000 inhabitants. A causal relationship was found betwen cysticercosis and epilepsy. The prevalenced of cysticercosis was 38 per 1 000 persons in the general population and 135.29 per 1 000 epileptic patients. The difference was highly statistically significant (X( 2)=74.17, p<10(-6)).     

Prevalence, knowledge, attitude, and practice of epilepsy in Kerala, South India

PURPOSE: To ascertain the prevalence and pattern of epilepsy and to characterize and quantify knowledge, attitude, and practice (KAP) toward epilepsy among the people of the state of Kerala, which is distinguished from the rest of India by a high level of literacy and health awareness of its population. METHODS: We conducted a door-to-door survey covering the entire population of 238,102 people residing in 43,681 households in a semiurban area of central Kerala. The screening questionnaire administered by medical social workers had a sensitivity of 100% for identifying persons with epilepsy. Neurologists examined all the individuals suspected of having epilepsy. We evaluated KAP toward epilepsy among 1,118 subjects (439 males and 679 females; mean age, 33.3 years; age range, 15-85 years) from households without epilepsy in the study area. RESULTS: Through a three-phased survey, we ascertained 1,175 cases (616 males and 559 females) with active epilepsy, providing a crude point prevalence ratio of 4.9 cases per 1,000 people and an age-adjusted prevalence ratio of 4.7 cases per 1,000 population. The highest age-specific prevalence rate of 6.5 per 1,000 occurred in the 10- to 19-year-old age group. Sex-specific prevalence rates did not significantly differ. The proportion of generalized and localization-related epilepsies was 58.8% and 30.6%, respectively. Ninety-nine percent of the KAP respondents had read or heard about epilepsy. Thirty-one percent and 27% thought epilepsy was a hereditary disorder and a form of insanity, respectively. About 40% of the respondents felt that individuals with epilepsy could not be properly educated or employed. Eleven percent would object to their children having contact with epileptic children. CONCLUSIONS: The prevalence and pattern of epilepsy in central Kerala, South India, do not differ from that of developed countries. Although the awareness of epilepsy among the people of Kerala was comparable to that of developed countries, the attitudes were much more negative. The need for educating the people of Kerala on epilepsy and for incorporating an adequate knowledge of epilepsy in the school curricula cannot be overemphasized.     

The epidemiology of epilepsy in Europe – a systematic review

Population-based epidemiological studies on epilepsy are available mainly from the UK and the Nordic, Baltic and western Mediterranean countries. No studies were identified from large areas of Europe, especially from the former eastern Europe (except the Baltic countries) and the eastern Mediterranean countries. Based on the prevalence of epilepsy in different studies and accounting for incomplete case identification the estimated number of children and adolescents in Europe with active epilepsy is 0.9 million (prevalence 4.5–5.0 per 1000), 1.9 million in ages 20–64 years (prevalence six per 1000) and 0.6 million in ages 65 years and older (prevalence seven per 1000). Approximately 20–30% of the epilepsy population have more than one seizure per month. Based on the age-specific incidence rates in European studies, the estimated number of new cases per year amongst European children and adolescents is 130 000 (incidence rate 70 per 100 000), 96 000 in adults 20–64 years (incidence rate 30 per 100 000) and 85 000 in the elderly 65 years and older (incidence 100 per 100 000). The proportion of both new and established cases with epilepsy in the young, adults and elderly in individual countries may differ substantially from total European distribution because of differences in age structure.     

The prevalence of epilepsy amongst school children in Izmir, Turkey.

OBJECTIVE: The aim of this study was to assess the prevalence of epilepsy among school children between the ages of 7-17 in Izmir province, in Turkey. METHODS: A cross sectional study was conducted. Sample size is calculated as 4654, from the target population of 420054 students. A stratified random sampling technique was used to select the schools located in Izmir Metropolitan area. For the 130 (2.8%) students whose families gave a positive 'epilepsy history' a telephone interview was conducted in order to verify the diagnosis and to evaluate a etiological factors. RESULTS: Response rate was 90.5% (4216 students). Out of the 130 students who had a positive epilepsy history, 47 (36.2%) were accepted as epilepsy 'cases'. The crude prevalence rates for females, males and the total study population were found respectively to the 11.3, 11.1 and 11.2 per thousand. Prevalence of active epilepsy rates for females, males and total study population were found respectively to be 4.5, 7.0 and 5.6 per thousand. CONCLUSION: The prevalence of epilepsy is higher in school-age children in Izmir province compared to that in developed countries.     

Low occurrence of epileptic seizures and epilepsy in a defined area of Northwest Greece

PurposeThe aim of the present study was to investigate the epidemiologic profile of epileptic seizures in the general population of a defined area of Northwest Greece. We also investigated the frequency of epilepsy in the same population.MethodsThe study area was the District of Corfu representing a population of about 113 000 inhabitants. Cases have been recorded prospectively in the frame of a systematic recording system, using multiple sources of retrieval, developed in the study area. All patients referred between 1 July 2004 and 30 June 2005, representing a case of diagnosed epilepsy or a new case of epileptic seizure, resident in the study area, were included in the study. Cases were confirmed and classified according to ILAE guidelines for epidemiologic studies on epilepsy.ResultsA total of 68 new cases of epileptic seizures were recorded. The age adjusted mean annual incidence rate was 58.4 (95% CI, 43.9–72.9) cases per 10⁵ inhabitants (55.6 for men, and 62.3 for women). Thirty-seven cases were classified as unprovoked seizures (32.6 cases per 10⁵), and 13 of them were related to stable conditions. The age adjusted prevalence estimate of diagnosed epilepsy was 226.1 (95% CI, 199.4–252.7) cases per 10⁵ inhabitants (223.3 for men, and 228.6 for women).DiscussionThe study population presents a relatively low incidence of unprovoked seizures and a low frequency of epilepsy, in comparison to other populations studied. The low incidence of unprovoked seizures seems to be related to a low occurrence of cases associated with conditions resulting to a static encephalopathy.     

An unknown quantity—The worldwide prevalence of epilepsy

The reported incidence (rate of new cases in a population) of epilepsy is consistently lower in high‐income than in lower‐income economies, whereas opinions vary regarding comparative prevalence rates (proportion of the population with epilepsy). For any condition that does not influence mortality, lifetime prevalence should approximate to the cumulative incidence. We suspected that epilepsy prevalence might be uniform throughout the world, whereas incidence is higher in resource‐poor countries. To test whether our suspicion was reasonable, we conducted a Medline search to estimate the prevalence of active and lifetime epilepsy in different economic areas throughout the world. We found that the range of estimated prevalence of epilepsy may be broadly similar throughout the world, but comparison is limited by lack of door‐to‐door studies in high‐income economies and by variations in the definitions of active epilepsy. We contend that any inconsistencies between incidence and prevalence are due largely to the excess premature death rate in people with epilepsy in lower‐income economies. Much of the variability in epidemiologic indices arises from differences in study methodology, definitions, and risk factors. The epidemiology of epilepsy, and particularly its mortality, needs thorough investigation using uniform definitions that do not include antiepileptic drug use; causes of death should be identified and actions, including treatment and education, should be taken to avoid preventable deaths. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here .     

Epidemiological survey of epilepsy in the primary school population in Buenos Aires

BACKGROUND: Most studies carried out in Latin America have shown greater rates of epilepsy and generalized seizures than those observed in developed countries, in spite of lower numbers of patients receiving treatment. To date, studies in Argentina have been insufficient to establish true prevalence. OBJECTIVE: To determine the prevalence of epilepsy in primary school children in Buenos Aires, together with rates of different seizure types, treatments prescribed, diagnoses made and number of inadequate therapies administered, as well as the relationship between epilepsy and learning difficulties. DESIGN AND METHOD: A cross-sectional study was carried out on 10% of the entire primary school population of Buenos Aires through randomized, systematic, representative and conglomerate sampling of public and private school students. A total of 26,270 responses were received (83.1% of the population) to a specially designed questionnaire, with 96.4% sensitivity and 41.5% specificity, respectively. Interviews were conducted in all probable epilepsy cases as well as in a random sample of probable negative ones. RESULTS: Eighty-four children with epilepsy were detected (lifetime prevalence 3.2 per thousand; active prevalence 2.6 per thousand), in whom generalized seizures predominated (57.1%). Ninety-three percent of cases diagnosed were currently under, or had previously received antiepileptic drug (AED) therapy. Almost 1% of the primary school population studied had a prior diagnosis and/or received AED for dysrhythmia or epilepsy. The percentage of grade repeaters in the general population and in children with epilepsy was 8.4 and 26.2%, respectively. CONCLUSIONS: (1) The prevalence of epilepsy in primary school children in Buenos Aires is similar to that reported for developed countries; (2) a slight prevalence for generalized seizures was observed; (3) 93% of cases received AEDs; (4) misdiagnoses and unnecessary treatments exceeded correct diagnoses and adequate therapy, and (5) disease presence and/or treatment were associated with poorer school performance.     

A population-based study of active and drug-resistant epilepsies in Northern Italy

Drug-resistant epilepsy (DRE) is defined by the International League Against Epilepsy as a failure of adequate trials of two tolerated, appropriately chosen, and used antiepileptic drugs to achieve sustained seizure freedom. Our aim was to calculate the following: (1) the prevalence of active epilepsy and DRE in a well-defined population of Northern Italy and (2) the proportion of incident cases developing DRE.The study population (146,506; year 2008) resided in the province of Lecco, Northern Italy. The medical records of 123 general practitioners were reviewed to identify patients with epilepsy, diagnosed by a neurologist during the period 2000–2008. The point prevalence of active epilepsy and DRE was calculated on December 31, 2008. A total of 747 prevalent patients with epilepsy, 684 patients with active epilepsy, and 342 incident cases were identified. The frequency of DRE was 15.6% (107/684) of all active epilepsies and 10.5% (36/342) of incident cases. The point prevalence was 0.73 per 1000. The standardized prevalence of DRE was 0.7 per 1000 (Italian population) and 0.8 per 1000 (world population).Our data indicate that 1/6 patients with active epilepsy in the general population has DRE, and 1/10 patients with newly diagnosed epilepsy will develop DRE within nine years from the diagnosis.     

Prevalence and pattern of multiple sclerosis in Benghazi, north-eastern Libya

A search for Libyan patients with multiple sclerosis (MS) was made in Benghazi, located on the southern Mediterranean coast at a latitude of 32 degrees N. Twenty-one clinically definite and probable cases were detected during the period July 1982-June 1984. On the basis of 2 probable incidental cases, the incidence for 1983 was 0.8 per 100 000 of the population at risk (10-50 years). On July 1st, 1984, the rough prevalence rate for the total population was 4 per 100 000 and the age-adjusted prevalence rate was 5.9 per 100 000. This study suggests that Benghazi falls within the medium frequency band for MS. High prevalence of brainstem involvement and cerebellar dysfunction and infrequent occurrence of the severe optic-spinal form and sphincter disturbance indicates that the present group of patients resembles Western pattern of MS as opposed to Asian MS.