Introduction: Acute seizures in patients with epilepsy are a potential of source of neurological damage; their causes must be researched.
Aim: To explore the epidemiology of acute seizure exacerbations in patients with epilepsy in a neurological emergency department in Mexico City.
Patients and methods: Descriptive prospective study of patients with a previous diagnosis of epilepsy that receive medical care in an emergency department due to acute seizures.
Results: 100 patients were analyzed between august 2016 and January 2017. 86 patients presented with focal seizures, of which 76 were focal to bilateral tonic-clonic, 2 with impaired awareness and motor onset, 3 with impaired awareness and non-motor onset, 1 without impaired awareness and motor onset, and 4 without impaired awareness and non-motor onset. 14 patients had generalized seizures with motor onset. The causes of exacerbation were as follows: 26 patients due to antiepileptic dose omission, 21 due to a unknown cause, 19 due to infection, 13 due to sleep deprivation, 3 due to stress, 3 were catamenial, 2 due to alcohol abuse and 3 due to other reasons. Of the 26 patients with dose omission, 10 were due to forgetfulness, 7 refused to comply with their prescription, 6 could not afford to buy their prescription and 3 had their prescription changed by another doctor.
Conclusions: In Mexico, antiepileptic drug dose omission represents up to 25% of patients with acute seizure exacerbations; increased patient education on epilepsy hygiene measures may be an area of opportunity for reducing its frequency.
Title: Epidemiologia del descontrol de la epilepsia en un servicio de urgencias neurologicas.
Introduccion. El descontrol de la epilepsia representa un potencial daño neurologico, por lo que deben investigarse sus causas. Objetivo. Explorar la epidemiologia de pacientes mexicanos con descontrol agudo de epilepsia en un servicio de urgencias neurologicas. Pacientes y metodos. Analisis prospectivo descriptivo de pacientes con diagnostico previo de epilepsia que acuden a un servicio de urgencias por descontrol de las crisis. Resultados. Se analizo a 100 pacientes entre agosto de 2016 y enero de 2017. Ochenta y seis fueron crisis focales, de las cuales 76 fueron focales a bilaterales tonicoclonicas, dos fueron con alteracion de la consciencia de inicio motor y tres de inicio no motor, una sin alteracion de la consciencia de inicio motor y cuatro de inicio no motor. Catorce fueron generalizadas de inicio generalizado motor. Las causas de descontrol fueron: 26 pacientes por falta de adhesion al tratamiento antiepileptico, 21 de causa desconocida, 19 por infeccion, 13 por privacion de sueño, 10 por ajuste de tratamiento, tres por estres, tres por menstruacion, dos por uso de alcohol y tres por otras razones. En los 26 pacientes con falta de adhesion, 10 fueron por olvido de dosis, siete por negarse a tomar el medicamento, seis por causas economicas y tres por indicacion de medico ajeno a la institucion. Conclusiones. En Mexico, la falta de adhesion al tratamiento representa un 25% de los casos de descontrol de la epilepsia, lo que es un area de oportunidad para incrementar la educacion de higiene de crisis y disminuir la frecuencia de estas.