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Original Article

Symptomatic epilepsy: a review of 208 patients

Epilepsia sintomática: revisión de 208 pacientes
Rev Neurol 1999 , 28(9), 846–849; https://doi.org/10.33588/rn.2809.98480
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Abstract

Summary. Objective. To determine the main etiological mechanisms of symptomatic epilepsy and its frequency according to age. Patients and methods. We made a retrospective analysis of 208 patients admitted during a period of four and a half years, studying the variables: age, sex and type of seizures: simple partial, secondarily generalized partial, complex partial, tonic-clonic, generalized tonic, and also EEG and neuroimaging. Results. The main etiological mechanisms found were: vascular (31.25%), alcoholic (12.01%), intracranial disorders (9.61%), traumatic (5.28%), degenerative (5.28%), infectious (2.88%) and cryptogenic (33.65%). In the last group there was an outstandingly large proportion of patients with silent infarcts. When considering vascular epilepsy, those seizures occurring during the acute phase of the stroke (24/65) are differentiated from those of late onset (41/65). In the latter there was a marked predominance of ischemic etiology (48.78% corresponded to extensive infarcts in the territory of the middle cerebral artery; 36.58% were associated with partial infarcts) probably because of the greater frequency of ischemic stroke as compared with hemorrhagic stroke. After the acute phase, the latency was of 10.68 ± 0.43 months and the most frequent seizures were tonic-clonic (48.78%). Conclusion. In persons under 30 years of age, etiology is multifactorial; between 30 and 50 years of age alcoholic epilepsy (39.53%) and traumatic epilepsy (11.62%) predominate; over the age of 50 years the cause was vascular in 43.5%. In the latter age group there was a high proportion of patients with heraldic seizures 

Resumen
Objetivo Determinar los principales mecanismos etiológicos de la epilepsia sintomática y su frecuencia según la edad.

Pacientes y métodos Se analizaron de forma retrospectiva 208 pacientes ingresados durante un período de 4 años y medio, y se estudiaron las variables edad, sexo y tipo de crisis: parcial simple, parcial secundariamente generalizada, parcial compleja, tonicoclónica, tónica generalizada, EEG y neuroimagen.

Resultados Los principales mecanismos etiológicos encontrados fueron: vascular (31,25%), enólica (12,01%), proceso intracraneal (9,61%), traumática (5,28%), degenerativa (5,28%), infecciosa (2,88%) y criptogénica (33,65%); destaca en este último grupo una elevada proporción de pacientes con infarto silente. Considerando la epilepsia vascular diferenciamos aquellas crisis acontecidas en la fase aguda del ictus (24/65) y las de aparición tardía (41/65). En estas últimas se observa un claro predominio de la etiología isquémica (48,78% corresponden a infartos extensos en el territorio de la arteria cerebral media; 36,58% se asocian a infartos parciales) probablemente por la mayor frecuencia del ictus isquémico frente al hemorrágico. Superada la fase aguda, la latencia es de 10,68 ± 0,43 meses y el tipo de crisis más frecuente es la tonicoclónica (48,78%).

Conclusiones En menores de 30 años la etiología es multifactorial; en el período comprendido entre los 30 y 50 años predomina la epilepsia enólica (39,53%) y traumática (11,62%), y en mayores de 50 años la causa vascular (43,5%). En este último grupo de edad destaca un elevado porcentaje de pacientes con crisis heráldicas
Keywords
Cryptogenic epilepsy
Etiology
Symptomatic acute seizure
Symptomatic epilepsy
Vascular epilepsy
Palabras Claves
Crisis aguda sintomática
Epilepsia criptogénica
Epilepsia sintomática
Epilepsia vascular
Etiología
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