Article type: Clinical Research/Original Article
Article
title: Course
and prognosis of adult-onset epilepsy in brazil: a cohort study
Journal: Epilepsy & Behavior
Year: 2020
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari Caprara,
Martim Tobias Bravo Leite, Juliana Oliveira Freitas Silveira, Paulo Gilberto Medeiros
Jauris, Josi Arend, Aline Kegler, Luiz Fernando Freire Royes, Michele Rechia
Fighera
E-mail: jamirrissardo@gmail.com
ABSTRACT
Background:
Most of the epilepsy longitudinal studies have analyzed children. However, in
endemic regions, such as Brazil, neurocysticercosis accounts for many
adult-onset epilepsy cases. So, the main objective of this study was to
identify the clinical predictors associated with drug-resistant adult-onset
epilepsy in Brazil during a long-term follow-up. Methods: We followed 302
individuals with adult-onset epilepsy for 9.8 years in our University Hospital.
Structured questionnaires about drug-resistant epilepsy were applied. The
presence of drug-resistant epilepsy was the primary outcome. We used multilevel
linear modeling in our data analysis. Results: Overall 47 (15.6%) individuals
presented drug-resistant epilepsy and the etiology was structural in 70.2% of
them, while infectious etiology was present in 8.5% of this group. Infectious
etiology occurred in 25.9% (n = 66) of the patients from the nondrug-resistant
group. Those with developmental delay were two times more likely to present
seizures. Structural epilepsy etiology was associated with an increased chance
of relapsing. Poor school performance and abnormal electroencephalogram were
also associated with an increased chance of seizures. Conclusion: The course of
epilepsy was favorable in the majority of our patients, and drug-resistant
epilepsy rates were similar to those found in other studies, although we
evaluated older individuals with higher levels of infectious etiology. Also, we
found that neurocysticercosis was associated with well-controlled epilepsy,
while structural epilepsy was directly related to the occurrence of seizures.
We also hypothesized that the smaller size of lesions found in
neurocysticercosis could contribute to a better treatment response.
Keywords: Epilepsy, drug-resistant, cohort, adult, prognosis, course
Full text available at:
https://www.epilepsybehavior.com/article/S1525-5050(20)30144-X/fulltext
DOI
10.1016/j.yebeh.2020.106969
Citation
Rissardo JP, Caprara ALF, Leite MTB, Silveira JOF, Jauris PGM, Arend J, Kegler A, Royes LFF, Fighera MR. Course and prognosis of adult-onset epilepsy in brazil: a cohort study. Epilepsy Behav 2020;105:106969