Evaluation of the clinical and electroencephalographic profile of a group of adult epileptic patients with controlled and uncontrolled seizures from the Epilepsy Clinic of the Hospital Universitário de Brasília

THESES

EVALUATION OF THE CLINICAL AND ELECTROENCEPHALOGRAPHIC PROFILE OF A GROUP OF ADULT EPILEPTIC PATIENTS WITH CONTROLLED AND UNCONTROLLED SEIZURES FROM THE EPILEPSY CLINIC OF THE HOSPITAL UNIVERSITÁRIO DE BRASÍLIA. (ABSTRACT)^*. DISSERTATION. BRASÍLIA, 1999.

MARINICE CABRAL MORAES^**

At the end of the Brain's Decade, epileptology was one of the fields of neuroscience that developed the most, because of the improvement of invasive and non invasive electroencephalographic methods, the progress in neuroimaging methods and in the techniques for epilepsy surgery, and last but not least the development of new antiepileptic drugs. In addition to that, the increasing concern about patients' readjustment and quality of life, makes necessary the re-evaluation of clinical and tecnological advances to ascertain the best possible treatment of these patients.

This study was carried out in order to outline the clinical electroencephalographic profile of a group of adult epileptic patients with controlled (GC) and uncontrolled (GNC) seizures and compare the results with the ones published in the literature. Also, we intend to evaluate the value of our protocol for the classification and out-hospital follow-up of these patients.

We have studied 70 epileptic adult patients from the Epilepsy Clinic of the Hospital Universitário de Brasília (HUB), during the period of June 1997 to September 1999, using a standardized protocol to evaluate various factors related to the history and evolution of the epileptic seizures, their clinical features, personal and family history, physical and neurological examination, and quality of life. The electroencephalographic study (EEG) was performed according to standard practice and lasted 20 minutes to one hour with the patient awake and during sleep. The differences between the two groups were analized by nonparametric statistical tests: the chi-square test with Pearson's correlation and significance level of 5% and the Fisher's test when the expected frequencies were less than five.

Although these samples did not allow us to identify statistically significant differences between the two groups, the study allowed the detection of some variables in the clinical electroencephalographic profile of the two groups: 1) the age of onset of seizures was more precocious in the GNC; 2) the presence of epileptic seizures before the current episode was greater in the GNC; 3) the presence of status epilepticus is rare in the GC and frequent in the GNC; 4) family history of epilepsy is more frequent in GNC; 5) partial seizures predominate in the two groups, but in the GNC simple partial seizures evolve to complex partial seizures and then to secondary generalized seizures; 6) auras are more frequent in GNC patients; 7) temporal lobe epilepsy with typical EEG was common in GNC, whereas extra-temporal epilepsies prevailed in GC; 8) a first EEG provided the diagnosis twice more frequently in GNC; and 9) quality of life is worse in GNC where 20% of the patients have no activities in life. The use of our protocol within this group allowed us to classify all but 2.8% of the epileptic seizures.

The completion of our studies that dedicated more specialized attention to epileptic patients with controlled and uncontrolled seizures and with low social-economic resources, allowed us to conclude that: (i) epilepsy, despite all the tecnological improvements, is still a pathology dependent on clinical diagnosis; (ii) it is possible to diagnose accurately and treat correctly based only on clinical data and routine EEG; (iii) detailed studies such as ours permit the correct selection of patients for more detailed exploration and for surgical treatment; (iv) the improvement on quality of life of patients with chronic illness improves not only the control of seizures, but also the understanding and acceptance of the disease. In summary, we have evidence that the treatment of epileptic patients does not depend heavily on the usage of novel techniques and procedures, but above all remains a matter dependent on providing adequate medical attention and care to the patient.

KEY WORDS: epilepsy, clinical-EEG form, prognosis.

**Address: SHIS QI 15 Conj. 11 casa 09, 71635-310 Brasília DF, Brasil.

*

Avaliação do perfil clínico e eletrencefalográfico de uma população de pacientes epilépticos adultos, controlados e não controlados, do Ambulatório de Epilepsia do Hospital Universitário de Brasília (Resumo). Dissertação de Mestrado, Faculdade de Saúde da Universidade de Brasília ¾ UnB. Orientadora: Áurea Nogueira de Melo.

Publication Dates

• Publication in this collection
  06 Dec 2000
• Date of issue
  Sept 2000