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From the Epilepsy and EEG unit (Drs. Coeytaux and Jallon) and the Division of Clinical Epidemiology (Drs. Galobardes and Morabia), University Hospital of Geneva, Switzerland.
Address correspondence and reprint requests to Dr. P. Jallon, Epilepsy and EEG Unit, Hôpitaux Universitaires. CH 1211 Geneva 14, Switzerland; e-mail: pierre.jallon{at}hcuge.ch
BACKGROUND: To determine the incidence, risk factors, and case fatality rate of status epilepticus (SE) in the French-speaking part of Switzerland.
METHODS: Between October 1, 1997 and September 30, 1998 all cases of SE referred to all the hospitals in the six cantons of the French-speaking part of Switzerland were identified by physicians working in emergency rooms, intensive care units, and electroencephalography departments; neurologists; and pediatricians from all hospitals in the area. Each case was validated and classified according to seizure type and etiology.
RESULTS: Over 1 year, 172 cases were identified, of whom 74 had a history of epilepsy (42.4%). The crude and standardized annual incidence rate were 9.9/100,000 (95% CI, 8.4 to 11.4) and 10.3/100,000 (95% CI, 8.7 to 11.9). The incidence rate was higher among children < 1 year of age and adults > 65 years, and among men than women. There were 108 cases of acute symptomatic SE (incidence: 6.2 per 1000), 49 cases of remote symptomatic SE, and 15 cases of unknown etiology. Case fatality rate was 7.6%.
CONCLUSIONS: The standardized incidence rate of SE in the French-speaking part of Switzerland was lower than that reported in Rochester, MN (18.3/100,000) and in the white population of Richmond, VA (20/100,000). The discrepancy may stem from the lack of a homogeneous, rigorous, and pragmatic definition of SE and the efficient management of acute repetitive seizures in this area.
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