Evolução eletrencefalográfica em mulheres com epilepsia de difícil controle

Azoubel, Ana Cláudia S.G.B.; Silveira, Diosely C.; Guerreiro, Carlos A.M.

doi:10.1590/S0004-282X1995000300003

Resumos

Foram revistos 444 traçados eletrencefalográfícos realizados durante o acompanhamento de 62 mulheres do Ambulatório de Epilepsia Catamenial do Hospital das Clínicas da UNICAMP com diagnóstico de epilepsia de difícil controle, que compareceram a esse ambulatório regularmente por um período mínimo de cinco anos. Dos 350 (78,84%) traçados anormais, 273 mostraram atividade epileptiforme e 77 anormalidades "não-epileptiformes". Segundo definições adotadas em relação à frequência das crises, encontramos 18 pacientes (29%) que apresentavam crises frequentes, 16 (25,8%) com crises muito frequentes, 12 (19,3%) com crises esporádicas e 16 (25,8%) com crises que se tornaram controladas durante o período de acompanhamento. Em relação aos achados de EEG, quatro pacientes (6,5%) mostraram EEGs sempre normais, 30 (48,4%) tiveram EEGs normais e anormais e 28 (45,2%) apenas EEGs anormais. Entre aquelas cujos EEGs sempre foram normais, duas estavam com crises controladas, uma com crises esporádicas e uma com crises frequentes. Das 30 pacientes com EEGs normais e anormais, 10 estavam controladas, 5 tinham crises esporádicas, 9 tinham crises frequentes e 6 tinham crises muito frequentes. No grupo de pacientes com EEGs sempre anormais, 4 estavam controladas, 6 tinham crises esporádicas, 8 tinham crises frequentes e 10 tinham crises muito frequentes. Em relação ao último EEG, ele foi normal em 7 (43,7%) das 16 pacientes que estavam controladas, em 3 (25%) das 12 pacientes com crises esporádicas, em 7 (38,9%) das 18 pacientes com crises frequentes e em nenhuma das pacientes com crises muito frequentes. Os pacientes que persistem com EEGs normais parecem ter melhor evolução que aqueles que persistem com EEGs anormais. Pela análise deste estudo, pode-se sugerir um papel relativo do EEG quanto ao prognóstico a longo prazo no controle das crises epilépticas, pois as pacientes que persistiram com EEGs normais aparentemente tiveram evolução clínica mais favorável que aquelas que persistiram com os EEGs alterados.

EEG; epilepsia na mulher; epilepsia refratária

We reviewed 444 EEGs of 62 women with medically refractary epilepsy, followed up for at least 5 years and that had 5 or more EEGs. According to our definitions we found 18 patients (29%) with frequent seizures, 16 (25.8%) with very frequent seizures, 16 (25.8%) with controlled seizures and 12 (19.3%). with occasional seizures. Four patients (6.5%) always showed normal EEGs, 30 (48.4%) had normal and abnormal EEGs and 28 (45.2%) only abnormal EEGs. Among the patients who had only normal EEGs, two had all seizures controlled, one had occasional seizures and one had frequent seizures. Among the patients who had normal and abnormal EEGs, 10 had controlled seizures, 5 had occasional seizures, 9 had frequent seizures and 6 had very frequent seizures. In the group of patients with always abnormal EEGs, 4 had controlled seizures, 6 had occasional seizures, 8 had frequent seizures, and 10 had very frequent seizures. In relation to the last EEG, it was normal in 7 (43.7%) of 16 patients with controlled seizures, in 3 (25%) of 12 patients with occasional seizures and in 7 (38.9%) of 18 patients with frequent seizures, and in none of the patients with very frequent seizures. The patients who had only normal EEGs seem to have a better outcome than those with abnormal EEGs. We observed that the last EEG was normal in 43.7% of the patients with controlled seizures. These data may suggest a relative importance of the EEG considering the long-term prognosis regarding seizure control.

EEG; epilepsy in women; refractary epilepsy

Ana Cláudia S.G.B. Azoubel; Diosely C. Silveira; Carlos A.M. Guerreiro

Setor de Epilepsia e Neurofisiologia Clínica do Departamento de Neurologia da Faculdade de Ciências Médicas (FCM) da Universidade Estadual de Campinas (UNICAMP)

RESUMO

Foram revistos 444 traçados eletrencefalográfícos realizados durante o acompanhamento de 62 mulheres do Ambulatório de Epilepsia Catamenial do Hospital das Clínicas da UNICAMP com diagnóstico de epilepsia de difícil controle, que compareceram a esse ambulatório regularmente por um período mínimo de cinco anos. Dos 350 (78,84%) traçados anormais, 273 mostraram atividade epileptiforme e 77 anormalidades "não-epileptiformes". Segundo definições adotadas em relação à frequência das crises, encontramos 18 pacientes (29%) que apresentavam crises frequentes, 16 (25,8%) com crises muito frequentes, 12 (19,3%) com crises esporádicas e 16 (25,8%) com crises que se tornaram controladas durante o período de acompanhamento. Em relação aos achados de EEG, quatro pacientes (6,5%) mostraram EEGs sempre normais, 30 (48,4%) tiveram EEGs normais e anormais e 28 (45,2%) apenas EEGs anormais. Entre aquelas cujos EEGs sempre foram normais, duas estavam com crises controladas, uma com crises esporádicas e uma com crises frequentes. Das 30 pacientes com EEGs normais e anormais, 10 estavam controladas, 5 tinham crises esporádicas, 9 tinham crises frequentes e 6 tinham crises muito frequentes. No grupo de pacientes com EEGs sempre anormais, 4 estavam controladas, 6 tinham crises esporádicas, 8 tinham crises frequentes e 10 tinham crises muito frequentes. Em relação ao último EEG, ele foi normal em 7 (43,7%) das 16 pacientes que estavam controladas, em 3 (25%) das 12 pacientes com crises esporádicas, em 7 (38,9%) das 18 pacientes com crises frequentes e em nenhuma das pacientes com crises muito frequentes. Os pacientes que persistem com EEGs normais parecem ter melhor evolução que aqueles que persistem com EEGs anormais. Pela análise deste estudo, pode-se sugerir um papel relativo do EEG quanto ao prognóstico a longo prazo no controle das crises epilépticas, pois as pacientes que persistiram com EEGs normais aparentemente tiveram evolução clínica mais favorável que aquelas que persistiram com os EEGs alterados.

Palavras-chave: EEG, epilepsia na mulher, epilepsia refratária.

SUMMARY

We reviewed 444 EEGs of 62 women with medically refractary epilepsy, followed up for at least 5 years and that had 5 or more EEGs. According to our definitions we found 18 patients (29%) with frequent seizures, 16 (25.8%) with very frequent seizures, 16 (25.8%) with controlled seizures and 12 (19.3%). with occasional seizures. Four patients (6.5%) always showed normal EEGs, 30 (48.4%) had normal and abnormal EEGs and 28 (45.2%) only abnormal EEGs. Among the patients who had only normal EEGs, two had all seizures controlled, one had occasional seizures and one had frequent seizures. Among the patients who had normal and abnormal EEGs, 10 had controlled seizures, 5 had occasional seizures, 9 had frequent seizures and 6 had very frequent seizures. In the group of patients with always abnormal EEGs, 4 had controlled seizures, 6 had occasional seizures, 8 had frequent seizures, and 10 had very frequent seizures. In relation to the last EEG, it was normal in 7 (43.7%) of 16 patients with controlled seizures, in 3 (25%) of 12 patients with occasional seizures and in 7 (38.9%) of 18 patients with frequent seizures, and in none of the patients with very frequent seizures. The patients who had only normal EEGs seem to have a better outcome than those with abnormal EEGs. We observed that the last EEG was normal in 43.7% of the patients with controlled seizures. These data may suggest a relative importance of the EEG considering the long-term prognosis regarding seizure control.

Key words:EEG, epilepsy in women, refractary epilepsy.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 20-março-1995.

Dr. Carlos A.M. Guerreiro - Departamento de Neurologia, FCM/UNICAMP - Caixa Postal 6111 - 13081-970 Campinas SP - Brasil.

1. Ajmone-Marsan C, Zivin L. Factors related to the occurrence of typical paroxysmal abnormalities in the EEG records of epileptic patients. Epilepsia 1970, 11:361-381.
2. Binnie CD. Electrencephalography. In Laidlaw J, Richens A, Oxley J. (eds). A textbook of epilepsy: London: Churchill Livingstone, 1988, p 236-306.
3. Cardoso TMO, Guerreiro CAM. Quando iniciar e interromper as drogas antiepilépticas. In Guerreiro CAM Guerreiro MM (eds). Epilepsia. São Paulo: Lemos-Editorial, 1993, p 143-150.
4. Daly DD. Epilepsy and syncope. In Daly DD, Pedley TA (eds). Current practice of clinical electroencephalophy. New York: Raven Press, 1990, p 269-334.
5. Dean JC, Penry JK. Discontinuation of antiepileptic drugs. In Levy R, Melbrum B, Penry FK, Dreifuss FE (eds). Antiepileptic drugs. Ed 3. New York: Raven Press, 1989, p 133-142.
6. Guerreiro CAM, Ramos MC. Premenstrual seizure increase: influence of age, duration of disease, seizure frequency, previous complaint of perimenstrual accentuation, EEG and CT findings. Arq Neuropsiquiatr 1991, 49:27-32.
7. Ives JR. Ambulatory EEG monitoring: current state of the art of event type recorders and their future applications. Ambulat Monit, 1989, 2:183-189.
8. Ives JR, Schomer DL, Blume HW. Presurgical evaluations using cassete EEG. In Ebersole JS (ed). Ambulatory EEG monitoring. New York: Raven Press, 1989, p 195-215.
9. Pedley TA. The EEG in epilepsy adults: Clinical EEG (course 244). American Academy of Neurology, May, 1992, p 120.
10. Sharbrough FW. Scalp-recorded ictal patterns in focal epilepsy. J Clin Neurophysiol. 1993, 10:262-267.
11. Shorvon SD. The routine EEG. In Dam M, Gram L (eds). Compreensive epileptology. New York: Raven Press, 1990, p 321-338.
12. Zivin L, Ajmone-Marsan C. Incidence and prognostic significance of non-epileptic subjects. Brain 1968, 91:751-778.

Evolução eletrencefalográfica em mulheres com epilepsia de difícil controle

Electroencephalographic evolution in women with medically refractary epilepsy

Datas de Publicação

Publicação nesta coleção
09 Dez 2010
Data do Fascículo
Set 1995

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

[1] 1. Ajmone-Marsan C, Zivin L. Factors related to the occurrence of typical paroxysmal abnormalities in the EEG records of epileptic patients. Epilepsia 1970, 11:361-381.

[2] 2. Binnie CD. Electrencephalography. In Laidlaw J, Richens A, Oxley J. (eds). A textbook of epilepsy: London: Churchill Livingstone, 1988, p 236-306.

[3] 3. Cardoso TMO, Guerreiro CAM. Quando iniciar e interromper as drogas antiepilépticas. In Guerreiro CAM Guerreiro MM (eds). Epilepsia. São Paulo: Lemos-Editorial, 1993, p 143-150.

[4] 4. Daly DD. Epilepsy and syncope. In Daly DD, Pedley TA (eds). Current practice of clinical electroencephalophy. New York: Raven Press, 1990, p 269-334.

[5] 5. Dean JC, Penry JK. Discontinuation of antiepileptic drugs. In Levy R, Melbrum B, Penry FK, Dreifuss FE (eds). Antiepileptic drugs. Ed 3. New York: Raven Press, 1989, p 133-142.

[6] 6. Guerreiro CAM, Ramos MC. Premenstrual seizure increase: influence of age, duration of disease, seizure frequency, previous complaint of perimenstrual accentuation, EEG and CT findings. Arq Neuropsiquiatr 1991, 49:27-32.

[7] 7. Ives JR. Ambulatory EEG monitoring: current state of the art of event type recorders and their future applications. Ambulat Monit, 1989, 2:183-189.

[8] 8. Ives JR, Schomer DL, Blume HW. Presurgical evaluations using cassete EEG. In Ebersole JS (ed). Ambulatory EEG monitoring. New York: Raven Press, 1989, p 195-215.

[9] 9. Pedley TA. The EEG in epilepsy adults: Clinical EEG (course 244). American Academy of Neurology, May, 1992, p 120.

[10] 10. Sharbrough FW. Scalp-recorded ictal patterns in focal epilepsy. J Clin Neurophysiol. 1993, 10:262-267.

[11] 11. Shorvon SD. The routine EEG. In Dam M, Gram L (eds). Compreensive epileptology. New York: Raven Press, 1990, p 321-338.

[12] 12. Zivin L, Ajmone-Marsan C. Incidence and prognostic significance of non-epileptic subjects. Brain 1968, 91:751-778.