Caracterización epidemiológica de la epilepsia del adulto subsidiaria de ingreso hospitalario

Abstract

There are few epidemiological studies specifically directed towards finding the features of the adult epileptic population requiring hospital admission. We proposed to analyze these features in a consecutive series of patients admitted to our department with epilepsy and find the prevalence of diagnoses classified as syndromes and epileptic seizures according to the classification of ILAE and their distribution according to age. We made a retrospective classification of the characteristics of the patients admitted to our department with the diagnosis of epilepsy during 1999. We divided the sample into three age groups: 18 30, 31 60 and >60 years. We calculated the absolute prevalence of the different types of crises and epileptic syndromes, the specific relative prevalence according to age groups and diagnostic category expressed with confidence intervals of 95%. The degree of statistical significance was obtained using the chi squared test of Mantel Haenszel. The sample group contained 96 patients (51% men and 49% women). There were 65.62% partial seizures, 21.87% generalized seizures and 12.5% pseudoseizures. The syndromes found included 60.7% of epilepsies related to site, 5.95% generalized epilepsies, 7% unclassified syndromes and 26.19% special syndromes. Of the symptomatic epilepsies, the commonest etiology was vascular, followed by toxic, tumoral and degenerative. The evolution of the relative prevalence according to age corresponded to three different patterns: ascending (partial crises and special syndromes), descending (pseudocrises and generalized epilepsy) and stable with peaks in middle age (generalized seizures, partial with generalization, unclassified syndromes, symptomatic and cryptogenic partial epileptic syndromes). The distribution according to seizures is similar to that reported in population studies. Special syndromes are much commoner than that reported in population studies, especially in epilepsies conditioned by the environment. The diagnosis of pseudoseizures are significantly commoner in the group of young adults. Partial seizures and special syndromes tended to be more frequent in older patients, whilst pseudocrises and generalized epilepsies were commoner in younger adults. The remaining seizures and syndromes predominated in the 18 30 year age group.