■为了确定到急诊科(ED)就诊的成年患者新发癫痫的病因和结果,提高医疗保健提供者对诊断的认识,从而改善结果。
这是一项在阿加汗大学医院急诊科进行的描述性回顾性研究,卡拉奇,巴基斯坦。成年患者(18岁及以上),从2019年1月1日至2020年6月30日提交给ED,连续包括新发作的癫痫发作。关于患者人口统计的描述性数据,癫痫发作类型,进行的调查,从患者的档案和电子记录中回顾性收集最终诊断和处置。癫痫发作的病因被分类为结构性(代谢,创伤,感染),遗传或特发性。即时结果报告为住院或从ED出院。
■共包括198例新发作的癫痫患者。大多数患者是在中年群体中发现的,即35至65岁(44.4%)。性别分布显示,女性比例略高(55.1%)。广泛性强直阵挛性癫痫发作是最常见的癫痫发作类型(74.2%),其次是全身强直(12.1%)和局灶性发作意识癫痫(7.5%)。在所有患者中,有8名患者(4%)没有发现病因,而在新发作癫痫发作的全部确诊原因中,发现脑部结构性病变是最常见的原因(89.6%),包括神经学(23.6%),传染性(4.2%),系统性(13%),代谢(7%)和毒理学(4%)分别引起。
■本研究探讨了向ED就诊的成年患者新发癫痫的各种病因。该研究强调需要一个当地指南来调查成年患者的新发作性癫痫发作,这将指导急诊医生进行适当的管理。从而确保更好的患者护理质量和结果。
UNASSIGNED: To identify the etiology and outcomes of new onset seizure in adult patients presenting to the Emergency Department (ED), to improve knowledge among healthcare providers regarding diagnosis and hence improve the outcomes.
UNASSIGNED: This was a descriptive retrospective study conducted at the Emergency Department of Aga Khan University Hospital, Karachi, Pakistan. Adult patients (18 years and above), presented to the ED from January 01, 2019 to June 30, 2020, with new onset seizure were included consecutively. Descriptive data on patient demographics, seizure types, investigations performed, final diagnosis and disposition were collected retrospectively from patient\'s file and electronic record. Etiologies of seizure were classified as structural (metabolic, trauma, infection), genetic or idiopathic. The immediate outcomes were reported as hospitalization or discharge from the ED.
UNASSIGNED: In total 198 patients with new onset seizure were included. Majority of the patients were found in middle age group i.e., 35 to 65 years (44.4%). Gender distribution showed slightly higher percentage of females (55.1%). Generalized tonic clonic seizures were found to be the most common type of seizures (74.2%), followed by generalized tonic (12.1%) and focal onset aware seizures (7.5%). Out of total patients no cause was identified in eight patients (4%), whereas in total confirmed causes of new onset seizures, structural lesions of brain were found to be the most common cause (89.6%%), including neurological (23.6%), infectious (4.2%), systemic (13%), metabolic (7%) and toxicological (4%) causes respectively.
UNASSIGNED: This study explores the various etiologies of new onset seizures in adult patients presenting to the ED. The study emphasizes the need for a local guideline for the investigation of new onset seizures in adult patients that would direct emergency physicians in respect of appropriate management, thus to ensure better quality of patient care and outcomes.