Aspectos epidemiológicos da epilepsia em São Paulo: um estudo da prevalência

Marino Jr., Raul; Cukiert, Arthur; Pinho, Eunice

doi:10.1590/S0004-282X1986000300004

Resumos

Muitos estudos epidemiológicos sobre a epilepsia foram realizados nas diferentes partes do mundo. Entretanto, a maioria desses dados foi colhida de hospitais, clínicas, médicos individuais e pequenas comunidades. Embora tais estudos tenham contribuído para nosso conhecimento sobre os fatores de risco da epilepsia, sua grande maioria não nos permite generalizações pois as taxas de prevalência do fenômeno não eram conhecidas para a população geral a partir da qual os dados foram retirados. A América Latina permaneceu sem dados epidemiológicos, especialmente em relação a taxas de prevalência, por muitos anos. Uma pesquisa domiciliar foi programada pela Liga Brasileira da Epilepsia na zona urbana da Cidade de São Paulo, a terceira maior metrópole do mundo: 13 milhões de habitantes em 1980. Uma amostra significativa de 2011 casas foi obtida por meios estatísticos equiprobabílísticos. Um total de 7604 entrevistas foram realizadas por 50 alunos de medicina e enfermagem sendo que 388 pessoas foram consideradas suspeitas e encaminhadas ao HCFMUSP para maiores esclarecimentos; 348 foram examinadas e em 91 o diagnóstico de epilepsia foi confirmado, originando taxa de prevalência de 11,9 por 1000.

Several studies on epidemiology of epilepsy were carried out in different parts of the world. However, the majority of their data was collected from hospitals, clinics, individual physicians and or small communities. Although these studies have contributed to our knowledge as to the risk factors of epilepsy, some of them have prevented us from further generalization, since the prevalence rates of the phenomena were not known for the entire population where from they were derived. Latin America has remained without epidemiological data, specialy prevalence rates, for many years. A house-to-house survey was programmed by the Brazilian League of Epilepsy in the urban area of S. Paulo City the third largest cosmopolitan city in the world: 13 million inhabitants in 1980. A significant sample of 2011 houses was chosen by statistical means. A total of 7603 interviews were performed by 50 senior medical students and nurses, and 388 persons were considered suspect and further referred to our University Hospital for other studies; 348 of these were examined, and in 91 the diagnosis of epilepsy was confirmed, thus producing a prevalence rate 11,9 per 1000.

Aspectos epidemiológicos da epilepsia em São Paulo: um estudo da prevalência

Epidemiological aspects of epilepsy in São Paulo, Brazil: a prevalence rate study

Raul Marino Jr.^I; Arthur Cukiert^II; Eunice Pinho^III

^IPresidente da Liga Brasileira de Epilepsia; Diretor da Divisão de Neurocirurgia Funcional do Instituto de Psiquiatria do Hospital das Clínicas (HC) da Faculdade de Medicina da Universidade de São Paulo (FMUSP)

^IIPresidente da Liga de Combate à Epilepsia do Centro Acadêmico Oswaldo Cruz da Faculdade de Medicina da Universidade de São Paulo

^IIIAssistente Doutora da Faculdade de Saúde Pública (Epidemiologia)

RESUMO

Muitos estudos epidemiológicos sobre a epilepsia foram realizados nas diferentes partes do mundo. Entretanto, a maioria desses dados foi colhida de hospitais, clínicas, médicos individuais e pequenas comunidades. Embora tais estudos tenham contribuído para nosso conhecimento sobre os fatores de risco da epilepsia, sua grande maioria não nos permite generalizações pois as taxas de prevalência do fenômeno não eram conhecidas para a população geral a partir da qual os dados foram retirados. A América Latina permaneceu sem dados epidemiológicos, especialmente em relação a taxas de prevalência, por muitos anos. Uma pesquisa domiciliar foi programada pela Liga Brasileira da Epilepsia na zona urbana da Cidade de São Paulo, a terceira maior metrópole do mundo: 13 milhões de habitantes em 1980. Uma amostra significativa de 2011 casas foi obtida por meios estatísticos equiprobabílísticos. Um total de 7604 entrevistas foram realizadas por 50 alunos de medicina e enfermagem sendo que 388 pessoas foram consideradas suspeitas e encaminhadas ao HCFMUSP para maiores esclarecimentos; 348 foram examinadas e em 91 o diagnóstico de epilepsia foi confirmado, originando taxa de prevalência de 11,9 por 1000.

SUMMARY

Several studies on epidemiology of epilepsy were carried out in different parts of the world. However, the majority of their data was collected from hospitals, clinics, individual physicians and or small communities. Although these studies have contributed to our knowledge as to the risk factors of epilepsy, some of them have prevented us from further generalization, since the prevalence rates of the phenomena were not known for the entire population where from they were derived. Latin America has remained without epidemiological data, specialy prevalence rates, for many years. A house-to-house survey was programmed by the Brazilian League of Epilepsy in the urban area of S. Paulo City the third largest cosmopolitan city in the world: 13 million inhabitants in 1980. A significant sample of 2011 houses was chosen by statistical means. A total of 7603 interviews were performed by 50 senior medical students and nurses, and 388 persons were considered suspect and further referred to our University Hospital for other studies; 348 of these were examined, and in 91 the diagnosis of epilepsy was confirmed, thus producing a prevalence rate 11,9 per 1000.

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Agradecimentos: Gostaríamos de externar nossos agradecimentos à Profa. Dra. Eunice Pinho Castro e Silva e a Maria Regina Alves Cardoso, epidemiologistas, sem as quais a realização deste estudo seria virtualmente impossível. Gostaríamos ainda de agradecer aos acadêmicos: Mareia Regina de Souza, Eduardo Pagani, Roberto Hyun Dae Shin, Élcio S.O. Vianna, Hugo Anteghini e José Abi Karan, por sua participação na coordenação dos trabalhos de campo, bem como a Biogalênica-Ciba Geigy e a Associação Nacional de Programas Econômicos e Sociais - ANPES pelo apoio financeiro.

Divisão de Neurocirurgia Funcional, Instituto de Psiquiatria - Hospital das Clínicas, FMUSP - Caixa Postal 8091 - 01000 - São Paulo, SP - Brasil.

1. ALTER, M.; MASLAND, R.L. & KURTZKE, J.F. - Proposed definitions and classifications of epilepsy for epidemiological purposes. In M. Alter & W.A. Hauser (eds.): The Epidemiology of Epilepsy: a Workshop. NINDS Monograph 14, Bethesda, 1972, pg. 147.
2. BALDWIN R.: DAVENS E. & HARRIS V.G. - The epilepsy program in public health. Amer. J. public Health 43:452, 1953.
3. BEAUSSART M.; FAOU R. & DEFAYE J. - Epidemiologic de l'epilepsie dans la region Nord-Pas-de-Calais: a propos de 12290 cas. Lille med. 25:183, 198.0.
4. BERAN R.G.; HALL, L.; PESCH A.; HO, P.; LAM, S.; LEUNG, P.Y.; CHEUNG, P. & FUNG, M. - Population prevalence of epilepsy in Sydney. Neuroepidemiology 1:201, 1982.
5. BIRD A.V.; HEINZ H.J. & KLINTWORTH G. - Convulsive disorders in Bantu mine workers. Epilepsia 3:175, 1962.
6. BREWIS M.; POSKANZER, D.C.; ROLAND, A. & MELLER, H. - Neurological disease in an English city. Acta neurol. scand. 42 suppl., 24:9, 1966.
7. DAVEMPORT, C.B. - The ecology of epilepsy: II. Racial and geographic distribution of epilepsy. Arch. Neurol. Psychiat. 9:554, 1923.
8. EDWARDS, T.I.; MCGILL, K.H.; ROWNTREE, L.G. - Local Board Examinations of Selective Service Registrants in Peacetime. D.C.U.S. Government Printing Office, Washington, 1942.
9. ELWES, R.D.; CHESTERMAN, P. & REYNOLDS, E.H. - Prognosis after a first untreated tonic-clonic seizure. Lancet 2:752, 1985.
10. GIELD, R. - The problem of epilepsy in Ethiopia. Trop. geogr. Med. 22:439, 1970.
11. GOMEZ I.G.; ARCINIEGAS, E. & TORRES, J. - Prevalence of epilepsy in Bogota, Colombia, Neurology 28:90, 1978.
12. GRAAF, A.S. - Epidemiological aspects of epilepsy in northern Norway. Epilepsia 15:291, 1974.
13. GRANIERI E.; ROSATI G.; TOLA R.; PAONI, M.; PAOLINO, M.; PAOLINO, E.; PINA, L. & MONETTI, V.C. - A descriptive study of epilepsy in the district of Copparo, Italy, 1964-1978. Epilepsia 24:502, 1983.
14. GUDMUNSSON G. - Epilepsy in Iceland: a clinical and epidemiological investigation. Acta neurol scand. 43, suppl. 25:1, 1966.
15. HAUSER, W.A. & KURLAND, L.T. - The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia 16:1, 1975.
16. HURST, L.A.; REEF, H.E. & SACHS, S.B. - Neuropsychiatry disorders in the Bantu: I. Convulsive disorders - a nilot study with special reference to genetic factors. South African med. J. 35:750, 1961.
17. JANZ D. - Epidemiologic und Classifikation von Epilepsien und epileptischen. Aktuel Neurol. 6:189, 1979.
18. KROHN, W. - A study in epilepsy in northern Norway: its frequency and character. Acta psychiat. neurol. scand. 36 (suppl. 150).-215, 1961.
19. KURLAND L.T. - The incidence and prevalence of convulsive disorders in a small urban community. Epilepsia 1:143, 1959.
20. LEIBOWITZ, U. & ALTER, M. - Epilepsy in Jerusalem, Israel. Epilepsia 9:87, 1968.
21. LESEEL S.; TORRES, J.M. & KURLAND, L.T. - Seizure disorders in a Guamanian village. Arch. Neurol. 7:37, 1962.
22. LEVY L.F. - Epilepsy in Rhodesia, Zambia and Malawi. Afr. J. med. Sci. 1:29, 1970.
23. MATHAI, K.V.; DUNN, D.P.; KURLAND, L.T. & REEDER, F.A. - Convulsive disorders in Mariana islands. Epilepsia 9:77, 196S.
24. OLIVARES, L. - Epilepsy in Mexico: a population study. Epilepsia 13:53, 1972.
25. PIRAUX, A. - Les epilepsies en Afrique Centrale. Wld. Neurol 1:510, 1960.
26. PONDS, D.A.; BROWELL, B.M. & STEIN, L.A. - Survey of epilepsy in fourteen general practices: part 1 (demographic and medical data). Psychiat. Neurol. Neurochir. 63:217, 1960.
27. ROSE, S.W.; PENRY, J.K.; MARKUSH, R.E.; RADLOFF, L.A. & PUTNAM, P.L, - Prevalence of epilepsy in children. Epilepsia. 14:133, 1972.
28. STANHOPE, J.M.; BRODY, J.A. & BRINK, E. - Convulsions among the Chamorro people of Guam, Mariana island. I. Seizure disorders. Amer. J. Epidemiol. 95: 292, 1972.
29. STANHOPE, J.M.; BRODY J.A.; BRINK E. & MORRIS C.L.. - Convulsions among the Chamorro people of Guam, Mariana Island: II. Febrile convulsions. Amer. J. Epidemiol. 95:299, 1972.
30. UEKI K. & SATO S. - An epidemiologic study of epilepsy in infancy and childhood and Niigata city. Psychiat. Neurol, paed. (Japan) 3:3, 1964.
31. WAJSBORT, J.; MARAL., N. & ALiFANDARY, J. - A study of the epidemiology of chronic epilepsy in Northern Israel. Epilepsia 8:105, 1966.
32. WISHIK S.M. - Handicapped children in Georgia: a study of prevalence, disability, needs and resources. Amer. J. public Health 46:195, 1956.

Datas de Publicação

Publicação nesta coleção
29 Jun 2011
Data do Fascículo
Set 1986

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

[1] 1. ALTER, M.; MASLAND, R.L. & KURTZKE, J.F. - Proposed definitions and classifications of epilepsy for epidemiological purposes. In M. Alter & W.A. Hauser (eds.): The Epidemiology of Epilepsy: a Workshop. NINDS Monograph 14, Bethesda, 1972, pg. 147.

[2] 2. BALDWIN R.: DAVENS E. & HARRIS V.G. - The epilepsy program in public health. Amer. J. public Health 43:452, 1953.

[3] 3. BEAUSSART M.; FAOU R. & DEFAYE J. - Epidemiologic de l'epilepsie dans la region Nord-Pas-de-Calais: a propos de 12290 cas. Lille med. 25:183, 198.0.

[4] 4. BERAN R.G.; HALL, L.; PESCH A.; HO, P.; LAM, S.; LEUNG, P.Y.; CHEUNG, P. & FUNG, M. - Population prevalence of epilepsy in Sydney. Neuroepidemiology 1:201, 1982.

[5] 5. BIRD A.V.; HEINZ H.J. & KLINTWORTH G. - Convulsive disorders in Bantu mine workers. Epilepsia 3:175, 1962.

[6] 6. BREWIS M.; POSKANZER, D.C.; ROLAND, A. & MELLER, H. - Neurological disease in an English city. Acta neurol. scand. 42 suppl., 24:9, 1966.

[7] 7. DAVEMPORT, C.B. - The ecology of epilepsy: II. Racial and geographic distribution of epilepsy. Arch. Neurol. Psychiat. 9:554, 1923.

[8] 8. EDWARDS, T.I.; MCGILL, K.H.; ROWNTREE, L.G. - Local Board Examinations of Selective Service Registrants in Peacetime. D.C.U.S. Government Printing Office, Washington, 1942.

[9] 9. ELWES, R.D.; CHESTERMAN, P. & REYNOLDS, E.H. - Prognosis after a first untreated tonic-clonic seizure. Lancet 2:752, 1985.

[10] 10. GIELD, R. - The problem of epilepsy in Ethiopia. Trop. geogr. Med. 22:439, 1970.

[11] 11. GOMEZ I.G.; ARCINIEGAS, E. & TORRES, J. - Prevalence of epilepsy in Bogota, Colombia, Neurology 28:90, 1978.

[12] 12. GRAAF, A.S. - Epidemiological aspects of epilepsy in northern Norway. Epilepsia 15:291, 1974.

[13] 13. GRANIERI E.; ROSATI G.; TOLA R.; PAONI, M.; PAOLINO, M.; PAOLINO, E.; PINA, L. & MONETTI, V.C. - A descriptive study of epilepsy in the district of Copparo, Italy, 1964-1978. Epilepsia 24:502, 1983.

[14] 14. GUDMUNSSON G. - Epilepsy in Iceland: a clinical and epidemiological investigation. Acta neurol scand. 43, suppl. 25:1, 1966.

[15] 15. HAUSER, W.A. & KURLAND, L.T. - The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia 16:1, 1975.

[16] 16. HURST, L.A.; REEF, H.E. & SACHS, S.B. - Neuropsychiatry disorders in the Bantu: I. Convulsive disorders - a nilot study with special reference to genetic factors. South African med. J. 35:750, 1961.

[17] 17. JANZ D. - Epidemiologic und Classifikation von Epilepsien und epileptischen. Aktuel Neurol. 6:189, 1979.

[18] 18. KROHN, W. - A study in epilepsy in northern Norway: its frequency and character. Acta psychiat. neurol. scand. 36 (suppl. 150).-215, 1961.

[19] 19. KURLAND L.T. - The incidence and prevalence of convulsive disorders in a small urban community. Epilepsia 1:143, 1959.

[20] 20. LEIBOWITZ, U. & ALTER, M. - Epilepsy in Jerusalem, Israel. Epilepsia 9:87, 1968.

[21] 21. LESEEL S.; TORRES, J.M. & KURLAND, L.T. - Seizure disorders in a Guamanian village. Arch. Neurol. 7:37, 1962.

[22] 22. LEVY L.F. - Epilepsy in Rhodesia, Zambia and Malawi. Afr. J. med. Sci. 1:29, 1970.

[23] 23. MATHAI, K.V.; DUNN, D.P.; KURLAND, L.T. & REEDER, F.A. - Convulsive disorders in Mariana islands. Epilepsia 9:77, 196S.

[24] 24. OLIVARES, L. - Epilepsy in Mexico: a population study. Epilepsia 13:53, 1972.

[25] 25. PIRAUX, A. - Les epilepsies en Afrique Centrale. Wld. Neurol 1:510, 1960.

[26] 26. PONDS, D.A.; BROWELL, B.M. & STEIN, L.A. - Survey of epilepsy in fourteen general practices: part 1 (demographic and medical data). Psychiat. Neurol. Neurochir. 63:217, 1960.

[27] 27. ROSE, S.W.; PENRY, J.K.; MARKUSH, R.E.; RADLOFF, L.A. & PUTNAM, P.L, - Prevalence of epilepsy in children. Epilepsia. 14:133, 1972.

[28] 28. STANHOPE, J.M.; BRODY, J.A. & BRINK, E. - Convulsions among the Chamorro people of Guam, Mariana island. I. Seizure disorders. Amer. J. Epidemiol. 95: 292, 1972.

[29] 29. STANHOPE, J.M.; BRODY J.A.; BRINK E. & MORRIS C.L.. - Convulsions among the Chamorro people of Guam, Mariana Island: II. Febrile convulsions. Amer. J. Epidemiol. 95:299, 1972.

[30] 30. UEKI K. & SATO S. - An epidemiologic study of epilepsy in infancy and childhood and Niigata city. Psychiat. Neurol, paed. (Japan) 3:3, 1964.

[31] 31. WAJSBORT, J.; MARAL., N. & ALiFANDARY, J. - A study of the epidemiology of chronic epilepsy in Northern Israel. Epilepsia 8:105, 1966.

[32] 32. WISHIK S.M. - Handicapped children in Georgia: a study of prevalence, disability, needs and resources. Amer. J. public Health 46:195, 1956.