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Título : | Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America |
Autor: | Carpio Rodas, Luis Arturo |
Correspondencia: | Carpio Rodas, Luis Arturo, arturo.carpio@ucuenca.edu.ec |
Palabras clave : | Acute symptomatic seizures First seizure Etiology Epilepsy Neurocysticercosis |
Área de conocimiento FRASCATI amplio: | 3. Ciencias Médicas y de la Salud |
Área de conocimiento FRASCATI detallado: | 3.2.30 Otros Temas de Medicina Clínica |
Área de conocimiento FRASCATI específico: | 3.2 Medicina Clínica |
Área de conocimiento UNESCO amplio: | 09 - Salud y Bienestar |
ÁArea de conocimiento UNESCO detallado: | 0912 - Medicina |
Área de conocimiento UNESCO específico: | 091 - Salud |
Fecha de publicación : | 2024 |
Volumen: | Volumen 0, número 0 |
Fuente: | Epilepsia Open |
metadata.dc.identifier.doi: | 10.1002/epi4.12900 |
Tipo: | ARTÍCULO |
Abstract: | There are limited data on first seizure (FS) among adults in low and middle-income countries. We describe findings from a prospective cohort study involving 180 adults presenting with seizures in emergency departments in five Latin American countries. Overall, 102 participants (56.7%) had acute symptomatic seizures (ASyS) while 78 (43.3%) had unprovoked seizures (UPS). Among patients with ASyS, 55 (53.9%) had structural causes, with stroke (n = 24, 23.5%), tumor (n = 10, 9.8%), and trauma (n = 3, 3%) being the most frequent. Nineteen patients (18.6%) had infectious causes, including four (4%) with meningoencephalitis, three (3%) neurocysticercosis, and two (2%) bacterial meningoencephalitis. Twenty patients (19.6%) had metabolic/toxic evidence, including four (4%) with uremic encephalopathy, two (2%) hyponatremia, and three (3%) acute alcohol intoxication. Immune dysfunction was present in seven (7%) patients and neurodegenerative in two (2%). Among participants with UPS, 45 (57.7%) had unknown etiology, 24 (30.7%) had evidence of structural disorders (remote symptomatic), four (5%) were related to infectious etiology (>7 days before the seizure), and five (6.4%) had genetic causes. During the 3- and 6-month follow-up, 29.8% and 14% of patients with UPS, respectively, experienced seizure recurrence, while 23.9% and 24.5% of patients with ASyS had seizure recurrence. Longer follow-up is necessary to assess seizure recurrence for patients with ASyS after the acute cause is resolved and to determine the 10-year risk of recurrence, which is part of the definition of epilepsy. Plain Language Summary: We monitored 180 adults who presented with their first seizure in emergency departments across five Latin American countries. Among these patients, 57% had acute symptomatic seizures, with structural causes such as stroke (23%), infection (17%), or tumor (10%) being more prevalent. Among the 43% with unprovoked seizures, 58% showed no identifiable acute cause, while 6.4% were due to genetics. Within 3 months after their initial seizure, 26.6% of individuals experienced a second seizure, with 11.9% continuing to have seizures in Months 3–6. Between Months 3 and 6, an additional 20% of patients encountered a second seizure. Research is needed to better understand the cause and prognosis of these patients to improve outcomes. |
URI : | http://dspace.ucuenca.edu.ec/handle/123456789/44037 https://www.scopus.com/record/display.uri?eid=2-s2.0-85185695350&doi=10.1002%2fepi4.12900&origin=inward&txGid=fe1c6819b0bac384f4053ce8cb98b906 |
URI Fuente: | https://onlinelibrary.wiley.com/journal/24709239 |
ISSN : | 2470-9239 |
Aparece en las colecciones: | Artículos
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