Crise epileptica unica, não provocada, em crianças : analise do risco de recorrencia e dos fatores prognosticos

AUTOR(ES)
DATA DE PUBLICAÇÃO

1999

RESUMO

We studied children who presented with a first seizure and carne to the outpatient clinic for childhood epilepsy from september/1989 to august/1998. The following risk factors were assessed: age, sex, type and etiology of the seizure, number of seizures in 24 hours, sleep state at time of seizure, status epilepticus (SE), Todd s paresis, prior febrile convulsions (FC), farnily history ofunprovoked seizures (FH), electroencephalogram (EEG) and computerized tomography (CT). Our purpose was to assess the risk factors in univariable and multivariable analisys. We included the patients who presented with a first unprovoked seizure and had an appointment no longer than 90 days after the seizure. We found two groups of patients according to the etiology: (a) cryptogenic cases (C C) and (b) remote syntomatic cases (RSC). This last group had only 15 patients and was excluded from the analysis. We studied only the CC with 213 patients. The study group included 124 boys and 89 girls. Partialseizure ocurred in 72% of 163 patients who could give the information about the beginning of the seizure. Seizures occurred during awake state in 165 (77 %) of the patients and during sleep in 48 (23%). Fourteen children had previous FC (7%), 12,with status epilepticus (6%),6 with Todd Paresis. Family history of US ocurred in 45 (21,5%) of 209 patients (we did not obtain this information in four children). The mean period for obtaining an EEG was 88 days. EEG was abnormal in 47 (22%) of the patients. One hundred eigthy two children (85%) had a CT examination that was abnormal in 17 (9,5%). Seizure recurrence was observed in 73 children (34%), during mean follow-up 2,1 years. The utilization of statistical method of Cox model, demonstrated that only patients with abnornal EEG for unprovoked seizures had a higher risk of recurrence (p =0,0001). After the first unprovoked seizure, estimate of recurrence by survival curves was 15% at first semester, 25% at first year, 37% at second year and 41% at third year. Variables like age, sex, type of seizure, number of seizures in 24 hours, sleep state at time of seizure, status epilepticus (SE), Todd s paresis, prior febrile convulsions (FC), family history of unprovoked seizures (FH), and computerized tomography (CT) did not correlated as recurrence factors. Sintomatic remote seizure group were not considered in this study due a small number of patients present. in the study

ASSUNTO(S)

epilepsia nas crianças epilepsia

ACESSO AO ARTIGO

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