Etiology of epilepsy a prospective study of 210 cases

Arruda, Walter Oleschko

doi:10.1590/S0004-282X1991000300003

Abstracts

The objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics (110 female, 100 male), aged 14-82 years (34.2±13.3). Patients less than 10 years-old and alcoholism were excluded. All underwent neurological examination, routine blood tests, EEG and CT-scan. Twenty patients (10.5%) were submitted to spinal tap for CSF examination. Neurological examination was abnormal in 26 (12.4%), the EEG in 68 (45.5%), and CT-scan in 93 (44.3%). According to the International Classification of Epileptic Seizures (1981), 101 (48.1%) have generalized seizures, 66 (31.4%) partial seizures secondarily generalized, 25 (11.8%) simple partial and complex partial seizures, and 14 (6.6%) generalized and partial seizures. Four patients (2.0%) could not be classified. In 125 (59.5%) patients the etiology was unknown. Neurocysticercosis accounted for 57 (27.1%) of cases, followed by cerebrovascular disease 8 (3.8%), perinatal damage 5 (2.4%), familial epilepsy 4 (1.9%), head injury 4 (1.9%), infective 1 (0.5%), and miscelanea 6 (2.8%).

Foram investigados prospectivamente 210 pacientes epilépticos crônicos (110 mulheres, 100 homens), idade variando de 14 a 82 anos (34,2±13,3) no sentido de estabelecer a etiologia de suas crises epilépticas. Pacientes com menos de 10 anos e com alcoolismo foram excluídos. Todos foram submetidos a anamnese, exames físico e, neurológico, exames laboratoriais de rotina, EEG e TC. Vinte pacientes (10,5%) foram submetidos a punção lombar para exame do LCR. O exame neurológico foi anormal em 26 (12,4%), o EEG em 68 (46.5%) e a TC em 93 (44,3%). De acordo com a Classificação Internacional de Epilepsia (1981), 101 (48,1%) apresentavam crises generalizadas primarias, 66 (31,4%) crises parciais secundariamente generalizadas, 25 (11,8%) crises parciais simples ou complexas e 14 (6,6%) crises parciais e crises generalizadas; 4 (2,0%) pacientes não puderam ser classificados. Em 125 pacientes (59,5%) a etiologia da epilepsia não foi estabelecida. Neurocisticercose foi a causa identificável mais comum, 57 casos (27,1%), seguida pelos acidentes cerebrovasculares 8 (3,8%), sofrimento perinatal 5 (2,4%), epilepsia familial 4 (1.9%), trauma craniano 4 (1,9%), infecção 1 (0.5%) e miscelânea 6 (2,8%).

CONTENTS CONTEÚDO

Walter Oleschko Arruda

Departamento de Neurologia, Unidade de Ciências Neurológicas e Serviço de Neurologia, Centro de Saúde Metropolitano, Secretaria de Estado da Saúde, Curitiba, Brasil

SUMMARY

The objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics (110 female, 100 male), aged 14-82 years (34.2±13.3). Patients less than 10 years-old and alcoholism were excluded. All underwent neurological examination, routine blood tests, EEG and CT-scan. Twenty patients (10.5%) were submitted to spinal tap for CSF examination. Neurological examination was abnormal in 26 (12.4%), the EEG in 68 (45.5%), and CT-scan in 93 (44.3%). According to the International Classification of Epileptic Seizures (1981), 101 (48.1%) have generalized seizures, 66 (31.4%) partial seizures secondarily generalized, 25 (11.8%) simple partial and complex partial seizures, and 14 (6.6%) generalized and partial seizures. Four patients (2.0%) could not be classified. In 125 (59.5%) patients the etiology was unknown. Neurocysticercosis accounted for 57 (27.1%) of cases, followed by cerebrovascular disease 8 (3.8%), perinatal damage 5 (2.4%), familial epilepsy 4 (1.9%), head injury 4 (1.9%), infective 1 (0.5%), and miscelanea 6 (2.8%).

RESUMO

Foram investigados prospectivamente 210 pacientes epilépticos crônicos (110 mulheres, 100 homens), idade variando de 14 a 82 anos (34,2±13,3) no sentido de estabelecer a etiologia de suas crises epilépticas. Pacientes com menos de 10 anos e com alcoolismo foram excluídos. Todos foram submetidos a anamnese, exames físico e, neurológico, exames laboratoriais de rotina, EEG e TC. Vinte pacientes (10,5%) foram submetidos a punção lombar para exame do LCR. O exame neurológico foi anormal em 26 (12,4%), o EEG em 68 (46.5%) e a TC em 93 (44,3%). De acordo com a Classificação Internacional de Epilepsia (1981), 101 (48,1%) apresentavam crises generalizadas primarias, 66 (31,4%) crises parciais secundariamente generalizadas, 25 (11,8%) crises parciais simples ou complexas e 14 (6,6%) crises parciais e crises generalizadas; 4 (2,0%) pacientes não puderam ser classificados. Em 125 pacientes (59,5%) a etiologia da epilepsia não foi estabelecida. Neurocisticercose foi a causa identificável mais comum, 57 casos (27,1%), seguida pelos acidentes cerebrovasculares 8 (3,8%), sofrimento perinatal 5 (2,4%), epilepsia familial 4 (1.9%), trauma craniano 4 (1,9%), infecção 1 (0.5%) e miscelânea 6 (2,8%).

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Dr. Walter O. Arruda - Rua Gonçalves Dias 713 - 80240 - Curitiba PR - Brasil.

1. Arruda WO. Neurocysticercosis and epilepsy. Proceedings of the XII International Congress of Electroencephalography and Clinical Neurophysiology, Rio de Janeiro, Brazil, 1990:6.
2. Arruda WO, Camargo NJ, Coelho R. Neurocysticercosis: an epidemiological study in two small rural communities. Arq. Neuro-Psiquiatria (São Paulo) 1990, 48:419.
3. Campbell GD, Farrell VJR. Brain scans, epilepsy and cerebral cysticercosis. S Afr Med J 1987, 72:885.
4. Chopra JS, Kaur U, Mahajan RC. Cysticerciasis and epilepsy: a clinical and serological study. Trans R Soc Trop Med Hyg 1981, 75:518.
5. Danesi MA. Classification of the epilepsies: an investigation of 945 patients in a developing country. Epilepsia 1985, 26:131.
6. Dreyfuss D. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 1981, 22:489.
7. Gastaut H, Gastaut JL. Computerized transverse axial tomography in epilepsy. Epilepsia 1976, 17:325.
8. Gomez JG, Arciniegas E, Torres J. Prevalence of epilepsy in Bogotá, Colombia. Neurology 1978, 28:90.
9. Gutierrez EJS, Ospona IG. La taeniasis y cysticercosis en México (Revisión bibliográfica). Salud Públ Mex 1986, 28:556.
10. Jennett WB. Predicting epilepsy after blunt head injury. Br Med J 1965, 1:1215.
11. Joshi V, Katiyar BC, Mohan PK, Misra S, Shukla GD. Profile of epilepsy in a developing country: a study of 1.000 patients based on the International Classification. Epilepsia 1977, 18:549.
12. Li SC, Schoenberg BS, Wang CC, Cheng XM, Zhou SS, Bolis CL. Epidemiology of epilepsy in urban areas of the People's Republic of China. Epilepsia 1985, 26:391.
13. Marino R Jr, Cukiert A, Pinho E. Aspectos epidemiológicos da epilepsia em São Paulo. Arq Neuro-Psiquiatria (São Paulo) 1986, 44:244.
14. Mazer S, Antoniuk A, Ditzel LFS, Araújo JC. The computed tomographic spectrum of cerebral cysticercosis. Comput Radiol 1983, 7:373.
15. McCormick GF, Zee CS, Heiden J. Cysticercosis cerebri: review of 127 cases. Arch Neurol 1982, 39:534.
16. McGaham JP, Dublin AB, Hill RP. The evaluation of seizure disorders by computerized tomography. J Neurosurg- 1979, 50:328.
17. Minguetti G, Ferreira MV. Computed tomography in neurocysticercosis. J Neurol Neurosurg Psychiat 1983, 46:936.
18. Naidoo DV, Pammenter MD, Moosa A, Van Dellen JR, Cosnett JE, Seventy black epileptics: cysticercosis, computed tomography and electro-encephalography. S Afr Med J 1987, 72:837.
19. Sander JWAS, Shorvon SD. Incidence and prevalence studies in epilepsy and their methodological problems: a review. J Neurol Neurosurg Psychiat 1987, 50:829.
20. Scharf D. Neurocysticercosis. Arch Neurol 1988, 45:777.
21. Shorvon SD, Farmer PJ. Epilepsy in developing countries: a review of epidemiological, sociocultural and treatment aspects. Epilepsia 1988, 29(S 1):36.
22. Sotelo J, Guerrero V, Rubio F. Neurocysticercosis: a new classification based on active and inactive forms. A study of 753 cases. Arch Intern Med 1985, 145:442.
23. Sriddharan R. Radhakrishnan K, Ashok PP, Mousa ME. Epidemiological and clinical study of epilepsy in Benghasi, Libya. Epilepsia 1986, 27:60.
24. Takayanagui OM. Neurocisticercose: I. Evolução clínico-laboratorial de 151 casos. Arq Neuro-Psiquiatria (São Paulo) 1990, 48:1.
25. Vianna LG, Macedo V, Costa JM, Mello P, Souza D. Estudo soroepidemiológico da cisticercose humana em Brasília, Distrito Federal. Rev Soe Bras Med Trop 1986, 19:149.

Etiology of epilepsy a prospective study of 210 cases

Etiologia da epilepsia: estudo prospectivo de 210 casos.

Publication Dates

Publication in this collection
22 Feb 2011
Date of issue
Sept 1991

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Arruda WO. Neurocysticercosis and epilepsy. Proceedings of the XII International Congress of Electroencephalography and Clinical Neurophysiology, Rio de Janeiro, Brazil, 1990:6.

[2] 2. Arruda WO, Camargo NJ, Coelho R. Neurocysticercosis: an epidemiological study in two small rural communities. Arq. Neuro-Psiquiatria (São Paulo) 1990, 48:419.

[3] 3. Campbell GD, Farrell VJR. Brain scans, epilepsy and cerebral cysticercosis. S Afr Med J 1987, 72:885.

[4] 4. Chopra JS, Kaur U, Mahajan RC. Cysticerciasis and epilepsy: a clinical and serological study. Trans R Soc Trop Med Hyg 1981, 75:518.

[5] 5. Danesi MA. Classification of the epilepsies: an investigation of 945 patients in a developing country. Epilepsia 1985, 26:131.

[6] 6. Dreyfuss D. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 1981, 22:489.

[7] 7. Gastaut H, Gastaut JL. Computerized transverse axial tomography in epilepsy. Epilepsia 1976, 17:325.

[8] 8. Gomez JG, Arciniegas E, Torres J. Prevalence of epilepsy in Bogotá, Colombia. Neurology 1978, 28:90.

[9] 9. Gutierrez EJS, Ospona IG. La taeniasis y cysticercosis en México (Revisión bibliográfica). Salud Públ Mex 1986, 28:556.

[10] 10. Jennett WB. Predicting epilepsy after blunt head injury. Br Med J 1965, 1:1215.

[11] 11. Joshi V, Katiyar BC, Mohan PK, Misra S, Shukla GD. Profile of epilepsy in a developing country: a study of 1.000 patients based on the International Classification. Epilepsia 1977, 18:549.

[12] 12. Li SC, Schoenberg BS, Wang CC, Cheng XM, Zhou SS, Bolis CL. Epidemiology of epilepsy in urban areas of the People's Republic of China. Epilepsia 1985, 26:391.

[13] 13. Marino R Jr, Cukiert A, Pinho E. Aspectos epidemiológicos da epilepsia em São Paulo. Arq Neuro-Psiquiatria (São Paulo) 1986, 44:244.

[14] 14. Mazer S, Antoniuk A, Ditzel LFS, Araújo JC. The computed tomographic spectrum of cerebral cysticercosis. Comput Radiol 1983, 7:373.

[15] 15. McCormick GF, Zee CS, Heiden J. Cysticercosis cerebri: review of 127 cases. Arch Neurol 1982, 39:534.

[16] 16. McGaham JP, Dublin AB, Hill RP. The evaluation of seizure disorders by computerized tomography. J Neurosurg- 1979, 50:328.

[17] 17. Minguetti G, Ferreira MV. Computed tomography in neurocysticercosis. J Neurol Neurosurg Psychiat 1983, 46:936.

[18] 18. Naidoo DV, Pammenter MD, Moosa A, Van Dellen JR, Cosnett JE, Seventy black epileptics: cysticercosis, computed tomography and electro-encephalography. S Afr Med J 1987, 72:837.

[19] 19. Sander JWAS, Shorvon SD. Incidence and prevalence studies in epilepsy and their methodological problems: a review. J Neurol Neurosurg Psychiat 1987, 50:829.

[20] 20. Scharf D. Neurocysticercosis. Arch Neurol 1988, 45:777.

[21] 21. Shorvon SD, Farmer PJ. Epilepsy in developing countries: a review of epidemiological, sociocultural and treatment aspects. Epilepsia 1988, 29(S 1):36.

[22] 22. Sotelo J, Guerrero V, Rubio F. Neurocysticercosis: a new classification based on active and inactive forms. A study of 753 cases. Arch Intern Med 1985, 145:442.

[23] 23. Sriddharan R. Radhakrishnan K, Ashok PP, Mousa ME. Epidemiological and clinical study of epilepsy in Benghasi, Libya. Epilepsia 1986, 27:60.

[24] 24. Takayanagui OM. Neurocisticercose: I. Evolução clínico-laboratorial de 151 casos. Arq Neuro-Psiquiatria (São Paulo) 1990, 48:1.

[25] 25. Vianna LG, Macedo V, Costa JM, Mello P, Souza D. Estudo soroepidemiológico da cisticercose humana em Brasília, Distrito Federal. Rev Soe Bras Med Trop 1986, 19:149.