Caracterização dos fatores clínico-epidemiológicos e das comorbidades neurológicas em pessoas com Epilepsia: Um estudo transversal no Nordeste do Brasil

Autores

DOI:

https://doi.org/10.33448/rsd-v13i7.45791

Palavras-chave:

Neurologia; Epilepsia; Comorbidades.

Resumo

Introdução: A epilepsia é uma doença neurológica crônica que cursa com comorbidades neuropsiquiátricas agravando ainda mais a morbidade e mortalidade de pessoas com epilepsia. Objetivo: Caracterizar o perfil clínico epidemiológico de pacientes com epilepsia correlacionando com as comorbidades associadas. Metodologia: Estudo de corte transversal do tipo analítico. Resultados: Foram analisados 220 prontuários. A idade média da primeira crise foi de 6,6 anos, com predomínio de epilepsia focal (lobo temporal). As alterações focais no exame de neuroimagem ocorreram em 42,2%, assim como as alterações focais no exame do eletroencefalograma em 48,5%. Quanto às comorbidades, 20,8% da população estudada apresenta algum tipo de transtorno do sono. O Déficit intelectual ocorreu em 53,5% (24,9%, nível moderado).  As cefaleias em 30,6%. Alterações do comportamento presentes em 20,8% e o Transtorno do espectro Autista em 4,1%. Houve relevâncias estatísticas entre epilepsia de lobo temporal e transtorno do sono, cefaleia e epilepsia parietal, politerapia farmacológica com pior controle de crises e DI. Conclusão: O diagnóstico de epilepsia do lobo temporal foi o mais prevalente. Quanto as etiologias, houve uma relação com explicação congruente, da epilepsia focal com etiologia estrutural, da epilepsia generalizada com etiologia genética, e da epilepsia desconhecida com a etiologia desconhecida.  As epilepsias focais apresentaram correlação com eletroencefalogramas com alterações focais, assim como a neuroimagem. A alta prevalência de comorbidades neuropsiquiátricas com relação bidirecional e fatores de riscos compartilhados com a doença de base, contrastando com a visão antiga de que estas comorbidades eram decorrentes do efeito das crises epilépticas.

Referências

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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19/07/2024

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SANTOS, C. W. S. dos .; ARAÚJO, R. A. de S. .; RAMOS, A. S. .; ANDRADE, C. L. .; SANTANA , H. P. R. de .; LEÃO, V. C. de S. .; MEDEIROS, F. L. de . Caracterização dos fatores clínico-epidemiológicos e das comorbidades neurológicas em pessoas com Epilepsia: Um estudo transversal no Nordeste do Brasil. Research, Society and Development, [S. l.], v. 13, n. 7, p. e9813745791, 2024. DOI: 10.33448/rsd-v13i7.45791. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/45791. Acesso em: 8 set. 2024.

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Ciências da Saúde