Incidence of status epilepticus in French-speaking Switzerland - (EPISTAR)

Background: To determine the incidence, risk factors, and case fatality rat e of status epilepticus (SE) in the French-speaking part of Switzerland. Me thods: Between October 1, 1997 and September 30, 1998 all cases of SE refer red to all the hospitals in the six cantons of the French-speaking part of Switzerland were identified by physicians working in emergency rooms, inten sive care units, and electroencephalography departments; neurologists; and pediatricians from all hospitals in the area. Each case was validated and c lassified 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 c rude and standardized annual incidence rate were 9.9/100,000 (95% CI, 8.4 t o 11.4) and 10.3/100,000 (95% CI, 8.7 to 11.9). The incidence rate was high er 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 10 00), 49 cases of remote symptomatic SE, and 15 cases of unknown etiology. C ase 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, V A (20/100,000). The discrepancy may stem from the lack of a homogeneous, ri gorous, and pragmatic definition of SE and the efficient management of acut e repetitive seizures in this area.