Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5631701 | Neurología | 2017 | 8 Pages |
ResumenObjetivoEstudio descriptivo de epilepsias sintomáticas, según edad de inicio, controladas en una Unidad de NeuropediatrÃa de referencia regional durante 3 añosPacientes y métodosNiños con diagnóstico de epilepsia sintomática, controlados del 1 de enero del 2008 hasta el 31 de diciembre del 2010ResultadosDe 4595 niños en el periodo de estudio, recibieron el diagnóstico de epilepsia 605 (13,17%), siendo 277 (45,79%) epilepsias sintomáticas. Entre los pacientes que iniciaron la epilepsia por debajo del año de vida predominan las de etiologÃa sintomática (67,72%). Entre los que la iniciaron entre 1-3 años, fueron sintomáticas el 61,39%. En cuanto a su etiologÃa, ha sido: encefalopatÃas prenatales (24,46% del total de epilepsias), encefalopatÃas perinatales (9,26%), encefalopatÃas posnatales (3,14%), encefalopatÃas metabólicas y degenerativas (1,98%), esclerosis mesial temporal (1,32%), sÃndromes neurocutáneos (2,64%), malformaciones vasculares (0,17%), cavernomas (0,17%) y tumores intracraneales (2,48%). Algunas etiologÃas inician sus manifestaciones epilépticas por debajo del año de vida, como el sÃndrome de Down, la lisencefalia genética, la infección congénita por citomegalovirus, la encefalopatÃa hipóxico-isquémica, las encefalopatÃas metabólicas o la esclerosis tuberosaConclusionesLa ausencia de una clasificación universalmente aceptada de los sÃndromes epilépticos dificulta comparaciones entre series. Sugerimos que todas las epilepsias son sintomáticas puesto que tienen causa, genética o adquirida. La edad de inicio orienta a determinadas etiologÃas. Una clasificación útil es la etiológica, con 2 grupos: un gran grupo con las etiologÃas establecidas o sÃndromes genéticos muy probables y otro de casos sin causa establecida, que con los avances en neuroimagen y genética cada vez será menor.
ObjectiveWe conducted a descriptive study of symptomatic epilepsy by age at onset in a cohort of patients who were followed up at a neuropaediatric department of a reference hospital over a 3-year periodPatients and methodsWe included all children with epilepsy who were followed up from January 1, 2008 to December 31, 2010ResultsOf the 4595 children seen during the study period, 605 (13.17%) were diagnosed with epilepsy; 277 (45.79%) of these had symptomatic epilepsy. Symptomatic epilepsy accounted for 67.72% and 61.39% of all epilepsies starting before one year of age, or between the ages of one and 3, respectively. The aetiologies of symptomatic epilepsy in our sample were: prenatal encephalopathies (24.46% of all epileptic patients), perinatal encephalopathies (9.26%), post-natal encephalopathies (3.14%), metabolic and degenerative encephalopathies (1.98%), mesial temporal sclerosis (1.32%), neurocutaneous syndromes (2.64%), vascular malformations (0.17%), cavernomas (0.17%), and intracranial tumours (2.48%). In some aetiologies, seizures begin before the age of one; these include Down syndrome, genetic lissencephaly, congenital cytomegalovirus infection, hypoxic-ischaemic encephalopathy, metabolic encephalopathies, and tuberous sclerosis.ConclusionsThe lack of a universally accepted classification of epileptic syndromes makes it difficult to compare series from different studies. We suggest that all epilepsies are symptomatic because they have a cause, whether genetic or acquired. The age of onset may point to specific aetiologies. Classifying epilepsy by aetiology might be a useful approach. We could establish 2 groups: a large group including epileptic syndromes with known aetiologies or associated with genetic syndromes which are very likely to cause epilepsy, and another group including epileptic syndromes with no known cause. Thanks to the advances in neuroimaging and genetics, the latter group is expected to become increasingly smaller.