Excess mortality in epilepsy in developing countries.

摘要

Epilepsy is one of the most common neurological disorders and has potentially serious consequences. Several studies have reported mortality rates two to three times higher in people with epilepsy than in the general population. This increase is partly a consequence of the seizures-eg, deaths in seizure-related accidents, status epilepticus, and sudden unexpected death-whereas some excess mortality is explained by the underlying disorder responsible for the epilepsy. Although 80% of the 50 million people who have epilepsy live in countries with poor resources,2 most epidemiological studies come from industrialised countries. The limited information available from developing countries suggests that the incidence of epilepsy is substantially higher than in more developed countries, whereas the prevalence seems to be closely similar. This apparent discrepancy in the incidence and prevalence of epilepsy between rich and poor countries might be explained by higher mortality in people with epilepsy in the developing world than in more affluent countries. Reasons could include inadequate resources for epilepsy care and lack of appropriate treatment for most people with epilepsy in developing countries. Unfortunately there have been no reliable studies on mortality in people with epilepsy from developing countries to test this hypothesis.