CLINICAL-ETIOLOGICAL AND THERAPEUTIC PROFILE OF 719
MEXICAN EPILEPTIC CHILDREN
Ruiz G M., Sosa M C.,
González A A.
Neurology Department. Instituto Nacional de Pediatría
Mexico City, Mexico
Rationale: To determine
clinical-etiological characteristics and therapeutic response of epileptic
outpatients in a third world country.
Methods: All patients who attended
the Epileptic Clinic in the Instituto Nacional de Pediatría, a third level
facility in Mexico City, between March and June 1998, were selected.
Clinical and therapeutic response data were registered. Three groups were
formed in terms of etiology. Statistical tests were two tailed with a= 0.05.
Results: 719 patients were studied.
Group I: Idiopathic (123 patients), Group II: Cryptogenic (132), and Group
III: Symptomatic (464). In-group I, 56% patients were female, in the other
groups, males prevailed. Mean onset age was Group I, 5.2 years (SD 3.7);
Group II, 1.9 years (SD 2.4); Group III 2.8 years (SD 3.1). Mean evolution
time was 5.3 years (SD 4) for all groups. Generalized seizures were the
most frequent varieties in all groups and complex partial was next in
frequency.
The
following epileptic syndromes were identified: in-group I, 28 patients had
tonic clonic idiopathic, 13 had absences, and 6 had benign Rolandic;
in-group II, 32 patients had focal cryptogenic; in-group III, 235 had
generalized symptomatic and 192 patients had focal symptomatic. Main
ethiologies in-group III was hypoxic ischemic encephalopathy (26%)
neuroinfections (22%) and cerebrovascular diseases (17%). Pharmacological
control was achieved in 108 (87%) patients of Group I, 84 (64%) of Group II
and 315 (68%) of Group III. No patient of Group I needed polipharmacy; 87%
patients had normal
psychomotor development.
Conclusions: Generalized seizures and symptomatic
varieties prevailed. Appropiate epileptic control and normal psychomotor
development were statistically better (p<0.00001) in patients of Group
I, when compared with the other groups.