Department of Neurology, Hospital of the Clinics of the Faculty of Medicine, University of São Paolo, São Paolo, SP, Brazil.
Pediatr Neurol. 2010 Feb;42(2):111-7. doi: 10.1016/j.pediatrneurol.2009.09.002.
This study assessed the prevalence rate of epilepsy and its causes in children and adolescents in one area of high deprivation in São Paulo, São Paulo, in Southeast Brazil. Between July 2005 and June 2006, 4947 families from a population of 22,013 inhabitants (including 10,405 children and adolescents between the ages of 0 and 16 years) living in the shantytown of Paraisópolis, were interviewed. In the first phase, a validated questionnaire was administered, to identify the occurrence of seizures. In the second phase, clinical history, neurologic examination, electroencephalography, and structural neuroimaging were performed. The diagnosis of epilepsy, including etiology, seizure types, and epileptic syndrome classification, was according to criteria of the International League Against Epilepsy. The screening phase identified 353 presumptive cases. In the second phase, 101 of these cases (33.8%) received the diagnosis of epilepsy. Crude prevalence of epilepsy was 9.7/1000 and prevalence of active epilepsy was 8.7/1000. Partial seizures were the most frequent seizure type (62/101). Symptomatic focal epilepsy was the most common form, and hypoxic-ischemic encephalopathy the most common etiology, reflecting the socioeconomic conditions of this specific population. Adequate public policies regarding perinatal assistance could help reduce the prevalence of epilepsy.
本研究评估了巴西东南部圣保罗市一个高贫困地区儿童和青少年癫痫的患病率及其病因。2005 年 7 月至 2006 年 6 月期间,对居住在 Paraisópolis 棚户区的 22013 名居民(包括 10405 名 0 至 16 岁的儿童和青少年)中的 4947 个家庭进行了访谈。在第一阶段,使用经过验证的问卷来确定是否存在癫痫发作。在第二阶段,进行了临床病史、神经检查、脑电图和结构神经影像学检查。根据国际抗癫痫联盟的标准,对癫痫的诊断,包括病因、发作类型和癫痫综合征分类进行了诊断。筛查阶段确定了 353 例疑似病例。在第二阶段,这些病例中有 101 例(33.8%)被诊断为癫痫。癫痫的粗患病率为 9.7/1000,活动性癫痫的患病率为 8.7/1000。部分性发作是最常见的发作类型(62/101)。症状性局灶性癫痫是最常见的形式,缺氧缺血性脑病是最常见的病因,反映了这一特定人群的社会经济状况。关于围产期保健的适当公共政策可能有助于降低癫痫的患病率。