Characterization of clinical-epidemiological factors and neurological comorbidities in people with Epilepsy: A cross-sectional study in Northeastern Brazil
DOI:
https://doi.org/10.33448/rsd-v13i7.45791Keywords:
Neurology; Epilepsy; Comorbidities.Abstract
Introduction: Epilepsy is a chronic neurological disease that presents with neuropsychiatric comorbidities, further aggravating the morbidity and mortality of people with epilepsy. Objective: To characterize the clinical epidemiological profile of patients with epilepsy, correlating with associated comorbidities. Methodology: Analytical cross-sectional study. Results: 220 medical records were analyzed. The average age at the first seizure was 6.6 years, with a predominance of focal epilepsy (temporal lobe). Focal changes in the neuroimaging examination occurred in 42.2%, as did focal changes in the electroencephalogram examination in 48.5%. As for comorbidities, 20.8% of the studied population has some type of sleep disorder. Intellectual deficit occurred in 53.5% (24.9%, moderate level). Headaches in 30.6%. Behavior changes present in 20.8% and Autism Spectrum Disorder in 4.1%. There were statistical relevances between temporal lobe epilepsy and sleep disorder, headache and parietal epilepsy, pharmacological polytherapy with worse seizure control and DI. Conclusion: The diagnosis of temporal lobe epilepsy was the most prevalent. As for etiologies, there was a relationship with a congruent explanation, focal epilepsy with structural etiology, generalized epilepsy with genetic etiology, and unknown epilepsy with unknown etiology. Focal epilepsies were correlated with electroencephalograms with focal changes, as well as neuroimaging. The high prevalence of neuropsychiatric comorbidities with a bidirectional relationship and shared risk factors with the underlying disease, contrasting with the old view that these comorbidities were due to the effect of epileptic seizures.
References
Aguiar, A. B., Albuquerque Filho, L. B. De ., Ramanzini, L. G., Silva, J. G. M. Da ., Lima, M. P. P. ., Ribas, M. Z. ., Paticcié, G. F. ., Noleto, F. M. . & Santos, J. C. C. Dos. (2024). Neuropsychiatric and cognitive comorbidities in epilepsy. Research, Society and Development, 12 (10). https://doi.org/10.33448/rsd-v12i10.43331
American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., Text Revision). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425787
Baldin, E., Hauser, W. A., Buchhalter, J. R., Hesdorffer, D. C., & Ottman, R. (2014). Yield of epileptiform electroencephalogram abnormalities in incident unprovoked seizures: A population-based study. Epilepsia, 55(9), 1389–1398. https://doi.org/10.1111/epi.12720
Banerjee, P. N., Filippi, D., & Allen Hauser, W. (2009). The descriptive epidemiology of epilepsy—A review. Epilepsy Research, 85(1), 31–45. https://doi.org/10.1016/j.eplepsyres.2009.03.003.
Belcastro, V., Striano, P., Kasteleijn-Nolst Trenité, D. G. A., Villa, M. P., & Parisi, P. (2011). Migralepsy, hemicrania epileptica, post-ictal headache and “ictal epileptic headache”: a proposal for terminology and classification revision. The Journal of Headache and Pain, 12(3), 289–294. https://doi.org/10.1007/s10194-011-0318-4
Berg, A. T., Altalib, H. H., & Devinsky, O. (2017). Psychiatric and behavioral comorbidities in epilepsy: A critical reappraisal. Epilepsia, 58(7), 1123–1130. https://doi.org/10.1111/epi.13766
Bernasconi, A., Cendes, F., Theodore, W. H., Gill, R. S., Koepp, M. J., Hogan, R. E., Jackson, G. D., Federico, P., Labate, A., Vaudano, A. E., Blümcke, I., Ryvlin, P., & Bernasconi, N. (2019). Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: A consensus report from the International League Against Epilepsy Neuroimaging Task Force. Epilepsia. https://doi.org/10.1111/epi.15612
Buainain, R. P., Oliveira, C. T. P., Marson, F. A. L., & Ortega, M. M. (2022). Epidemiologic Profile of Patients With Epilepsy in a Region of Southeast Brazil: Data From a Referral Center. Frontiers in neurology, 13, 822537. https://doi.org/10.3389/fneur.2022.822537
Buckley, A. W., & Holmes, G. L. (2016). Epilepsy and Autism. Cold Spring Harbor Perspectives in Medicine, 6(4), a022749. https://doi.org/10.1101/cshperspect.a022749
Censo Demográfico 2022. (n.d.). Censo Demográfico 2022 - IBGE. https://censo2022.ibge.gov.br/
Duko, B., Ayalew, M., & Toma, A. (2020). The epidemiology of headaches among patients with epilepsy: a systematic review and meta-analysis. The Journal of Headache and Pain, 21(1). https://doi.org/10.1186/s10194-020-1074-0
Ferrari, C. M. M., de Sousa, R. M. C., & Castro, L. H. M. (2013). Factors associated with treatment non-adherence in patients with epilepsy in Brazil. Seizure, 22(5), 384–389. https://doi.org/10.1016/j.seizure.2013.02.006
Fiest, K. M., Sauro, K. M., Wiebe, S., Patten, S. B., Kwon, C. S., Dykeman, J., Pringsheim, T., Lorenzetti, D. L., & Jetté, N. (2017). Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology, 88(3), 296–303. https://doi.org/10.1212/WNL.0000000000003509
Fisher, R. S., Acevedo, C., Arzimanoglou, A., Bogacz, A., Cross, J. H., Elger, C. E., Engel, J., Jr, Forsgren, L., French, J. A., Glynn, M., Hesdorffer, D. C., Lee, B. I., Mathern, G. W., Moshé, S. L., Perucca, E., Scheffer, I. E., Tomson, T., Watanabe, M., & Wiebe, S. (2014). ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 55(4), 475–482. https://doi.org/10.1111/epi.12550
Garg, D., Charlesworth, L., & Shukla, G. (2022). Sleep and Temporal Lobe Epilepsy - Associations, Mechanisms and Treatment Implications. Frontiers in human neuroscience, 16, 849899. https://doi.org/10.3389/fnhum.2022.849899
Giussani, G., Bianchi, E., Beretta, S., Carone, D., DiFrancesco, J. C., Stabile, A., Zanchi, C., Pirovano, M., Trentini, C., Padovano, G., Colombo, M., Cereda, D., Tinti, L., Scanziani, S., Gasparini, S., Bogliun, G., Ferrarese, C., Beghi, E., & PRO-LONG Study Group (2021). Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long-term outcome. Epilepsia, 62(10), 2395–2404. https://doi.org/10.1111/epi.17022
Gloss, D., Pargeon, K., Pack, A., Varma, J., French, J. A., Tolchin, B., Dlugos, D. J., Mikati, M. A., Harden, C., & AAN Guideline Subcommittee (2021). Antiseizure Medication Withdrawal in Seizure-Free Patients: Practice Advisory Update Summary: Report of the AAN Guideline Subcommittee. Neurology, 97(23), 1072–1081. https://doi.org/10.1212/WNL.0000000000012944
Helmstaedter, C., & Witt, J.-A. (2017). Epilepsy and cognition – A bidirectional relationship? Seizure, 49, 83–89. https://doi.org/10.1016/j.seizure.2017.02.017
Hoxhaj, P., Habiya, S. K., Sayabugari, R., Balaji, R., Xavier, R., Ahmad, A., Khanam, M., Kachhadia, M. P., Patel, T., Abdin, Z. U., Haider, A., Nazir, Z., M. popatbhai. (2023). Investigating the Impact of Epilepsy on Cognitive Function: A Narrative Review. Cureus, 15(6). https://doi.org/10.7759/cureus.41223
Ito, M., Adachi, N., Nakamura, F., Koyama, T., Okamura, T., Kato, M., Kanemoto, K., Nakano, T., Matsuura, M., & Hara, S. (2003). Multi-center study on post-ictal headache in patients with localization-related epilepsy. Psychiatry and Clinical Neurosciences, 57(4), 385–389. https://doi.org/10.1046/j.1440-1819.2003.01136.x
Keezer, M. R., Sisodiya, S. M., & Sander, J. W. (2016). Comorbidities of epilepsy: current concepts and future perspectives. The Lancet. Neurology, 15(1), 106–115. https://doi.org/10.1016/S1474-4422(15)00225-2
Kim DW, Lee SK. Headache and Epilepsy. J Epilepsy Res. 2017 Jun 30;7(1):7-15. 10.14581/jer.17002.
Laia Grau-López, Jiménez, M., Jordi Ciurans, Barambio, S., Fumanal, A., & Becerra, J. L. (2017). Diagnostic Yield of Routine Electroencephalography With Concurrent Video Recording in Detecting Interictal Epileptiform Discharges in Relation to Reasons for Request: A Prospective Study of 1,080 Video-Electroencephalograms. Journal of Clinical Neurophysiology, 34(5), 434–437. https://doi.org/10.1097/wnp.0000000000000390
Liu, X., Sun, X., Sun, C., Zou, M., Chen, Y., Huang, J., Wu, L., & Chen, W.-X. (2021). Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis. Autism, 26(1), 33–50. https://doi.org/10.1177/13623613211045029
Moore, J. L., Carvalho, D. Z., St Louis, E. K., & Bazil, C. (2021). Sleep and Epilepsy: a Focused Review of Pathophysiology, Clinical Syndromes, Co-morbidities, and Therapy. Neurotherapeutics, 18(1), 170–180. https://doi.org/10.1007/s13311-021-01021-w
Namusisi, J., Kyoyagala, S., Nantongo, J., Kyewalyanga, M., Sabiiti, S., Murorunkwere, A., Josephine Nambi Najjuma, Nakibuuka, J., Kaddumukasa, M., Sajatovic, M., & Kalubi, P. (2023). Poor Seizure Control Among Children Attending a Tertiary Hospital in South Western Uganda – A Retrospective Study. International Journal of General Medicine, Volume 16, 895–904. https://doi.org/10.2147/ijgm.s398318
Nevitt, S. J., Sudell, M., Cividini, S., Marson, A. G., & Tudur Smith, C. (2022). Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data. Cochrane Database of Systematic Reviews, 2022(4). https://doi.org/10.1002/14651858.cd011412.pub4
Nobili, L., Frauscher, B., Eriksson, S., Gibbs, S. A., Halasz, P., Lambert, I., Manni, R., Peter‐Derex, L., Proserpio, P., Provini, F., de Weerd, A., & Parrino, L. (2022). Sleep and epilepsy: A snapshot of knowledge and future research lines. Journal of Sleep Research, 31(4), e13622. https://doi.org/10.1111/jsr.13622
Orozco-Hernández, J. P., Quintero-Moreno, J. F., Marín-Medina, D. S., Castaño-Montoya, J. P., Hernández-Coral, P., Pineda, M., Vélez, J. D., Villada, H. C., Martínez, J. W., & Lizcano, A. (2019). Perfil clínico y sociodemográfico de la epilepsia en adultos de un centro de referencia de Colombia. Neurología, 34(7), 437–444. https://doi.org/10.1016/j.nrl.2017.02.013
Paula, C. S., Fombonne, E., Gadia, C., Tuchman, R., & Rosanoff, M. (2011). Autism in Brazil: perspectives from science and society. Revista Da Associação Médica Brasileira, 57, 2–5. https://doi.org/10.1590/S0104-42302011000100002
Jakob Paungarttner, Quartana, M., Patti, L., Barbora Sklenárová, Fatemeh Farham, Inés Hernando Jiménez, M. Gokcen Soylu, Irina Maria Vlad, Semih Tasdelen, Mateu, T., Marsico, O., Reina, F., Tischler, V., & Lampl, C. (2024). Migraine - a borderland disease to epilepsy: near it but not of it. The Journal of Headache and Pain, 25(1). https://doi.org/10.1186/s10194-024-01719-0
Riney, K., Bogacz, A., Somerville, E., Hirsch, E., Nabbout, R., Scheffer, I. E., Zuberi, S. M., Alsaadi, T., Jain, S., French, J., Specchio, N., Trinka, E., Wiebe, S., Auvin, S., Cabral-Lim, L., Naidoo, A., Perucca, E., Moshé, S. L., Wirrell, E. C., & Tinuper, P. (2022). International League Against Epilepsy classification and definition of epilepsy syndromes with onset at a variable age: position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia, 63(6), 1443–1474. https://doi.org/10.1111/epi.17240
Salinsky M, Kanter R, Dasheiff RM. Effectiveness of multiple EEGs in supporting the diagnosis of epilepsy: an operational curve. Epilepsia. 1987 Jul-28(4):331-4. 10.1111/j.1528-1157.1987.tb03652.x.
Semah, F., Picot, M. C., Adam, C., Broglin, D., Arzimanoglou, A., Bazin, B., Cavalcanti, D., & Baulac, M. (1998). Is the underlying cause of epilepsy a major prognostic factor for recurrence?. Neurology, 51(5), 1256–1262. https://doi.org/10.1212/wnl.51.5.1256
St Louis, E. K., Rosenfeld, W. E., & Bramley, T. (2009). Antiepileptic drug monotherapy: the initial approach in epilepsy management. Current neuropharmacology, 7(2), 77–82. https://doi.org/10.2174/157015909788848866
Téllez-Zenteno, J. F., & Hernández-Ronquillo, L. (2012). A review of the epidemiology of temporal lobe epilepsy. Epilepsy research and treatment, 2012, 630853. https://doi.org/10.1155/2012/630853
Wang X, Cheng Z. (2020). Cross-Sectional Studies: Strengths, Weaknesses, and Recommendations. Chest. ;158(7):S65-S71. do10.1016/j.chest.2020.03.012.
Whealy, M. A., Myburgh, A., Bredesen, T. J., & Britton, J. W. (2019). Headache in epilepsy: A prospective observational study. Epilepsia open, 4(4), 593–598. https://doi.org/10.1002/epi4.12363
World Health Organization. (2024, February 7). Epilepsy. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/epilepsy
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Copyright (c) 2024 Clauhan Williams Soares dos Santos; Rodrigo André de Souza Araújo; Alana Soares Ramos; Clênia Leite Andrade; Hanna Priscila Rodrigues de Santana ; Vítor Caron de Souza Leão; Fabíola Lys de Medeiros
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