title: Epidemiology of status epilepticus in a rural area of northern Italy: a 2-year population-based study.
abstract: We performed a 2-year population-based study on status epilepticus (SE) in adults in the rural area of Lugo di Romagna, northern Italy, to verify whether an area of low-level urbanization has a lower risk of occurrence of SE (as recently suggested), different clinical features and short-term prognosis than areas of high-level urbanization. We found crude and age- and sex-adjusted annual incidence rates of SE of 16.5/100 000 and 11.6/100 000, respectively. In patients under 60 years crude incidence was 2.9/100 000 and in the elderly (>/=60 years) 38.6/100 000. Acute symptomatic SE accounted for 30% and a cerebrovascular pathology was the most frequently associated etiologic condition (60%). A history of seizures was reported in 41% of patients. The first therapeutic intervention was mainly benzodiazepines (lorazepam 46%; diazepam 33%). The 30-day case fatality was 7%. We observed that the adult population of an area with a low level of urbanization has the same risk for SE, clinical features and short-term prognosis as European urban areas. The only contrasting result is the 30-day case fatality of 7% against the 39% found in the other Italian study (Bologna), despite the similarity of the SE features in these two areas of the same region. We infer that the short-term prognosis of SE could also be considerably influenced by differences in health service organization (and hence management) possibly due to different levels of urbanization.
authors.affiliation: Laboratorio di Neuroepidemiologia, Dipartimento di Scienze Neurologiche, Università di Bologna, Bologna, Italy. vigna@interfree.it
authors.forename: L
authors.initials: L
authors.lastname: Vignatelli
authors.forename: R
authors.initials: R
authors.lastname: Rinaldi
authors.forename: M
authors.initials: M
authors.lastname: Galeotti
authors.forename: P
authors.initials: P
authors.lastname: de Carolis
authors.forename: R
authors.initials: R
authors.lastname: D'Alessandro
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D003625:Data Collection; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012424:Rural Population; D017678:Sex Distribution; D013226:Status Epilepticus / Q000188:drug therapy / Q000453:epidemiology*; D014507:Urbanization
chemical_list: D000927:Anticonvulsants