Tabla. Características clínicas de los tres grupos de pacientes con crisis con semiología focal (en porcentaje). Cada característica se consideró como presente cuando se observó al menos en una crisis durante los primeros seis meses de evolución. |
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SP |
CA |
Otras |
|
Una única crisis |
18 |
26 b |
13 |
Sexo varón |
56 |
58 |
54 |
Edad de 3-4 años al inicio de las crisis |
44 c |
43 c |
12 |
Convulsiones febriles previas |
18 |
19 a |
9 |
Crisis de más de cinco minutos de duración |
63 c |
47 c |
18 |
Estado epiléptico (crisis de más de 30 minutos) |
22 a |
16 a |
8 |
Más de una crisis en 24 horas |
26 |
10 c |
35 |
Emesis ictal (arcadas, náuseas o vómitos) |
10 c |
100 c |
8 |
Otros signos autonómicos |
26 b |
34 c |
8 |
Afectación de conciencia |
89 |
97 a |
86 |
Bloqueo del habla o disartria |
11 |
11 |
21 |
Sialorrea prominente |
7 |
8 a |
20 |
Contracciones tónicas o clónicas hemifaciales |
4 a |
8 b |
26 |
Versión cefálica u ocular |
67 b |
50 |
37 |
Hipotonía generalizada (incluye episodios síncope-like) |
15 |
21 b |
9 |
Contracciones clónicas de una extremidad superior |
7 |
5 b |
18 |
Crisis hemiclónicas |
11 |
8 |
10 |
Contracciones clónicas generalizadas |
22 c |
31 c |
67 |
Síntomas visuales |
11 a |
6 |
2 |
Cefalea |
26 b |
14 a |
6 |
Mirada fija |
22 |
42 a |
29 |
Automatismos |
4 |
16 |
11 |
Más de la mitad de las crisis durante el sueño o al despertar |
74 c |
45 |
36 |
CA: crisis autonómicas sin déficits neurológicos; Otras: resto de pacientes con crisis con semiología focal; SP: síndrome de Panayiotopoulos. a p < 0,05; b p < 0,01; c p < 0,001 (en comparación con el grupo ‘Otras’). |
Frequency, semiology and prognosis of Panayiotopoulos syndrome Introduction. Panayiotopoulos syndrome (PS) is an epileptic syndrome of childhood. Until now only a small number of studies have been published about this syndrome. Aim. To study the frequency, semiology and prognosis of PS. Patients and methods. all patients with one or more unprovoked seizures seen at our hospital between 1 June 1994 and 1 March 2011 (n = 827) were included and prospectively followed until 30 April 2018. A diagnosis of PS was made in patients that fulfilled all the following criteria at six month of evolution: seizures with predominantly autonomic symptoms, presence of high amplitude, ‘functional morphology’, focal spikes and slow wave complexes in any location, absence of a previous neurological deficit and normal neuroimaging. Results. 27 cases (3,3%) met the diagnostic criteria. Semiology of the seizures was similar to that described by other authors. 88% of these cases attained a 3-year initial remission without antiepileptic treatment (three years both without seizures and without treatment). 62 cases (7,5%) met all the diagnostic criteria with the exception of the presence of the EEG features. Semiology of these cases was similar and 85% attained a 3-year initial remission without antiepileptic treatment. Conclusions. In daily practice, patients with a clinical picture suggestive of PS but without the typical EEG features are common. This group of patients also have a good outcome. Key words. Child. Diagnosis. Epidemiology. Epilepsy. Prognosis. |