Epilepsia em idade pediátrica – casuística da consulta de pediatria de um hospital distrital

Abstract

Introduction and Objectives: Epilepsy represents one of the most frequent neurologic diseases in children and adolescents, with a prevalence of four to six cases per 1000 children. The aim of the present study is to analyze clinical and epidemiological characteristics of patients with epilepsy followed in a pediatric outpatient department of a level II hospital.Methods: Retrospective review of the clinical files of patients followed in a pediatric-neurologic diseases consultation between May 2009 and June 2014. The epileptic seizures were classified according to the International League Against Epilepsy.Results: The study included 42 patients, 54.8% males, with a median age at diagnosis of 78 months (IQR 5-205). Four children (9.5%) had a history of prematurity, three (7.1%) needed resuscitation maneuvers after birth, one (2.4%) had a previous neurologic impairment and three (7.1%) had a history of febrile seizures. Family history of epilepsy was positive in 53.7% of cases. Seizure types were generalized in 60% of the children, predominantly tonic-clonic. After the first seizure, 98% of children performed electroencephalography, that was abnormal in 69% of the cases and in these patients treatment was initiated with anti-epileptic drugs. The brain imaging was performed in 27 patients (64.3%) and was abnormal in four (15.4%). Of the 42 patients, half had new seizures. Because they had recurrent seizures, it was necessary to add a new anti-epileptic drug in seven children (16.7%). Morbidities were detected in 30% of children, especially cognitive impairment (21.4%).Conclusion: The clinical history and the electroencephalography are essential for the diagnosis of epilepsy. The prognosis is good in most children. Longitudinal studies should be planned in order to determine the national incidence of epilepsy in children and its characteristics.