The investigation of diagnosis and treatment for status epilepticus in some hospitals of China_West China Medical Journal

Authors：

 TIAN Linyu , GUO Jianan , LIU Wenyu , HAO Xiaoting , CHEN Jiani , YAN Bo , ZHOU Dong

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

TIAN Linyu, Email: tianlinyu@sina.com

Keywords：

Status epilepticus; Convulsive status epilepticus; Questionnaire survey

DOI：

10.7507/1002-0179.201703219

Video：

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Objective To investigate the diagnosis and treatment of status epilepticus in hospitals of different levels and the knowledge of status epilepticus in clinical physicians, in order to better guide clinical education in the future. Methods From August 2014 to August 2015, a questionnaire was designed and used to investigate the general situation of the hospital, the diagnosis of status epilepticus and the clinical practice among trainee doctors and students in the epilepsy training class in the Neurological Intensive Care Unit and the Department of Neurology of West China Hospital, Sichuan University. The results of the investigation were statistically analyzed. Results Ninety questionnaires were distributed, and all the questionnaires were retrieved with validity. The number of investigated physicians was 42 (46.7%) from the Department of Neurology, 6 (6.7%) from the Department of Neurosurgery, 30 (33.3%) from the Intensive Care Unit and 12 (13.3%) from other departments. Twenty-seven (30.0%) physicians were from class Ⅲ grade A hospitals, 31 (34.4%) from class Ⅲ grade B hospitals, and 32 (35.6%) from class Ⅱ grade A hospitals. All the class Ⅲ hospitals and 53.1% of class Ⅱ hospitals had electroencephalograph monitoring facilities. The proportion of status epilepticus patients ranged from 0.5% to 10.0% in different hospitals. There were great differences in the identification and treatment of convulsive status epilepticus among different hospitals. Conclusions Status epilepticus is a common emergency. Questionnaire survey is an effective means to reflect the difference in identifying and treating the emergency among different departments and hospitals. It can guide clinical education and promote the identification and treatment of the emergency more accurately in doctors of all levels.

Citation： TIAN Linyu, GUO Jianan, LIU Wenyu, HAO Xiaoting, CHEN Jiani, YAN Bo, ZHOU Dong. The investigation of diagnosis and treatment for status epilepticus in some hospitals of China. West China Medical Journal, 2017, 32(5): 655-658. doi: 10.7507/1002-0179.201703219 Copy

1.	Lowenstein DH, Bleck T, Macdonald RL. It’s time to revise the definition of status epilepticus. Epilepsia, 1999, 40(1): 120-122.
2.	Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015, 56(10): 1515-1523.
3.	Varelas PN, Corry J, Rehman M, et al. Management of status epilepticus in neurologicalversus medical intensive care unit: does it matter?. Neurocrit Care, 2013, 19(1): 4-9.
4.	James J, Riviello J, Claassen J, et al. The neurocritical care society status epilepticus guideline writing committee. Treatment of status epilepticus: an international survey of experts. Neurocrit Care, 2013, 18(2): 193-200.
5.	Sutter R, Marsch S, Fuhr P, et al. Mortality and recovery from refractory status epilepticus in the intensive care unit: a 7-year observational study. Epilepsia, 2013, 54(3): 502-511.
6.	Betjemann JP, Josephson SA, Lowenstein DH, et al. Trends in status epilepticus-related hospitalizations and mortality: redefined in US practice over time. JAMA Neurol, 2015, 72(6): 650-655.
7.	Gilmore EJ, Hirsch LJ. Epilepsy: status epilepticus epidemiology--tracking a moving target. Nat Rev Neurol, 2015, 11(7): 377-378.
8.	Santillanes G, Luc Q. Emergency department management of seizures in pediatric patients. Pediatr Emerg Med Pract, 2015, 12(3): 1-25; quiz 26-27.
9.	Trinka E, Cock H, Hesdorffer D, et al. 癫痫持续状态的定义与分类-ILAE 工作组关于癫痫持续状态分类的报告. 癫痫杂志, 2016, 2(5): 437-445.
10.	Novy J, Logroscino G, Rossetti AO. Refractory status epilepticus: a prospective observational study. Epilepsia, 2010, 51(2): 251-256.
11.	Mayer SA, Claassen J, Lokin J, et al. Refractory status epilepticus: frequency, risk factors, and impact on outcome. Arch Neurol, 2002, 59(2): 205-210.
12.	中华医学会神经病学分会神经重症协作组. 惊厥性癫痫持续状态监护与治疗(成人)中国专家共识. 中华神经科杂志, 2014, 47(9): 661-666.
13.	Brophy GM, Bell R, Claassen J, et al. Neurocritical care society status epilepticus guideline writing committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care, 2012, 17(1): 3-23.
14.	Meierkord H, Boon P, Engelsen B, et al. European federation of neurological societies. EFNS guideline on the management of status epilepticus in adults. Eur J Neurol, 2010, 17(3): 348-355.
15.	Glauser T, Shinnar S, Gloss D, et al. Evidence-Based guideline: treatment of convulsive status epilepticus in children and adults: report of the guideline committee of the American Epilepsy society. Epilepsy Curr, 2016, 16(1): 48-61.
16.	Kellinghaus C, Stögbauer F. Treatment of status epilepticus in a large community hospital. Epilepsy Behav, 2012, 23(3): 235-240.
17.	Agan K, Afsar N, Midi I, et al. Predictors of refractoriness in a Turkish status epilepticus data bank. Epilepsy Behav, 2009, 14(4): 651-654.
18.	Chen L, Zhou B, Li JM, et al. Clinical features of convulsive status epilepticus: a study of 220 cases in western China. Eur J Neurol, 2009, 16(4): 444-449.
19.	李花, 胡湘蜀, 费凌霞, 等. 非惊厥性癫痫持续状态临床及脑电图表现四例. 脑与神经疾病杂志, 2013, 21(3): 161-164.
20.	卢强, 金丽日, 周祥琴, 等. 额叶非惊厥性癫痫持续状态临床和脑电图特征. 协和医学杂志, 2012, 3(3): 318-322.

1. Lowenstein DH, Bleck T, Macdonald RL. It’s time to revise the definition of status epilepticus. Epilepsia, 1999, 40(1): 120-122.
2. Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015, 56(10): 1515-1523.
3. Varelas PN, Corry J, Rehman M, et al. Management of status epilepticus in neurologicalversus medical intensive care unit: does it matter?. Neurocrit Care, 2013, 19(1): 4-9.
4. James J, Riviello J, Claassen J, et al. The neurocritical care society status epilepticus guideline writing committee. Treatment of status epilepticus: an international survey of experts. Neurocrit Care, 2013, 18(2): 193-200.
5. Sutter R, Marsch S, Fuhr P, et al. Mortality and recovery from refractory status epilepticus in the intensive care unit: a 7-year observational study. Epilepsia, 2013, 54(3): 502-511.
6. Betjemann JP, Josephson SA, Lowenstein DH, et al. Trends in status epilepticus-related hospitalizations and mortality: redefined in US practice over time. JAMA Neurol, 2015, 72(6): 650-655.
7. Gilmore EJ, Hirsch LJ. Epilepsy: status epilepticus epidemiology--tracking a moving target. Nat Rev Neurol, 2015, 11(7): 377-378.
8. Santillanes G, Luc Q. Emergency department management of seizures in pediatric patients. Pediatr Emerg Med Pract, 2015, 12(3): 1-25; quiz 26-27.
9. Trinka E, Cock H, Hesdorffer D, et al. 癫痫持续状态的定义与分类-ILAE 工作组关于癫痫持续状态分类的报告. 癫痫杂志, 2016, 2(5): 437-445.
10. Novy J, Logroscino G, Rossetti AO. Refractory status epilepticus: a prospective observational study. Epilepsia, 2010, 51(2): 251-256.
11. Mayer SA, Claassen J, Lokin J, et al. Refractory status epilepticus: frequency, risk factors, and impact on outcome. Arch Neurol, 2002, 59(2): 205-210.
12. 中华医学会神经病学分会神经重症协作组. 惊厥性癫痫持续状态监护与治疗(成人)中国专家共识. 中华神经科杂志, 2014, 47(9): 661-666.
13. Brophy GM, Bell R, Claassen J, et al. Neurocritical care society status epilepticus guideline writing committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care, 2012, 17(1): 3-23.
14. Meierkord H, Boon P, Engelsen B, et al. European federation of neurological societies. EFNS guideline on the management of status epilepticus in adults. Eur J Neurol, 2010, 17(3): 348-355.
15. Glauser T, Shinnar S, Gloss D, et al. Evidence-Based guideline: treatment of convulsive status epilepticus in children and adults: report of the guideline committee of the American Epilepsy society. Epilepsy Curr, 2016, 16(1): 48-61.
16. Kellinghaus C, Stögbauer F. Treatment of status epilepticus in a large community hospital. Epilepsy Behav, 2012, 23(3): 235-240.
17. Agan K, Afsar N, Midi I, et al. Predictors of refractoriness in a Turkish status epilepticus data bank. Epilepsy Behav, 2009, 14(4): 651-654.
18. Chen L, Zhou B, Li JM, et al. Clinical features of convulsive status epilepticus: a study of 220 cases in western China. Eur J Neurol, 2009, 16(4): 444-449.
19. 李花, 胡湘蜀, 费凌霞, 等. 非惊厥性癫痫持续状态临床及脑电图表现四例. 脑与神经疾病杂志, 2013, 21(3): 161-164.
20. 卢强, 金丽日, 周祥琴, 等. 额叶非惊厥性癫痫持续状态临床和脑电图特征. 协和医学杂志, 2012, 3(3): 318-322.

West China Medical Journal

The investigation of diagnosis and treatment for status epilepticus in some hospitals of China

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