NeuroUnal Research Group, Neurology Unit, Universidad Nacional de Colombia, Bogotá, Colombia.
Fundación Instituto Neurológico de Colombia, Medellín, Colombia.
Epilepsia Open. 2024 Aug;9(4):1437-1444. doi: 10.1002/epi4.12995. Epub 2024 Jun 15.
To describe the sociodemographic and clinical characteristics of imprisoned patients with epilepsy seen at Samaritana University Hospital (HUS) in Bogotá D.C., between January 2017 and November 2020.
Cross-sectional cohort study of inmate patients over 18 years of age seen at HUS between January 2017 and November 2020, with a discharge diagnosis of epilepsy. A descriptive univariate analysis of patient sociodemographic and clinical characteristics was carried out.
Overall, 92 patients were included, 95.7% were males with a median age of 32 years (IQR: 26-44); 65% were assessed in the outpatient clinic; median hospital length of stay was 2 days (IQR: 0) and 7.6% required admission to the intensive care unit; 75% had focal onset epilepsy, 63.04% with undetermined etiology 31.52% with structural causes. Polytherapy was found in 53.3%, valproic acid being the most frequently used antiseizure medication in 59.78%; lack of adherence was reported in 15.22% and inadequate seizure control in 81.52%; status epilepticus occurred in 5.34%. A total of 31 EEG recordings and 53 brain images were performed, of which, 29% and 39.62%, respectively, were abnormal. Non-epileptic paroxysmal events were diagnosed in 5.34%, while organic or psychiatric comorbidities were found in 25%, and the use of psychoactive substances was documented in 17.39%. Upon discharge, 93.47% had no disability, and only 45.65% returned for outpatient follow-up.
The clinical profile was of men in the fourth decade of life with focal onset epilepsy characterized by high seizure frequency, most of whom were receiving antiseizure medication, with a high proportion of polytherapy. The results are a point of departure for prospective studies designed to identify points to intervene and improve healthcare for inmates with epilepsy.
Inmates are a vulnerable proportion of persons with epilepsy. In this group there are significant differences compared to the general population, especially with greater psychiatric comorbidity and worse control of epileptic seizures due to difficulties in accessing medical care, antiseizure medication and diagnostic tests. We found that the most characteristic population is made up of men in the fourth decade of life with a high frequency of seizures, most of whom were receiving multiple antiseizure medication This study is the first of its kind in Latin America and it is an initial approach to epilepsy in inmates.
描述 2017 年 1 月至 2020 年 11 月期间在波哥大特区 Samaritan 大学医院（HUS）就诊的被监禁癫痫患者的社会人口学和临床特征。
对 2017 年 1 月至 2020 年 11 月期间在 HUS 就诊的年龄在 18 岁以上、出院诊断为癫痫的囚犯患者进行了一项横断面队列研究。对患者的社会人口学和临床特征进行了描述性的单变量分析。
共纳入 92 例患者，其中 95.7%为男性，中位年龄为 32 岁（IQR：26-44）；65%在门诊接受评估；中位住院时间为 2 天（IQR：0），7.6%需要入住重症监护病房；75%为局灶性癫痫发作，63.04%病因不明，31.52%有结构性病因。发现 53.3%的患者接受了多种药物治疗，59.78%使用丙戊酸作为最常用的抗癫痫药物；15.22%的患者报告药物依从性差，81.52%的患者癫痫发作控制不佳；5.34%的患者发生癫痫持续状态。共进行了 31 次脑电图检查和 53 次脑部影像学检查，其中分别有 29%和 39.62%异常。诊断出 5.34%的非癫痫性阵发性事件，25%发现有器质性或精神科合并症，17.39%有精神活性物质使用史。出院时，93.47%的患者无残疾，仅有 45.65%的患者返回门诊随访。
临床特征为 40 多岁的男性，表现为局灶性癫痫发作，其特征为癫痫发作频率高，大多数患者正在服用抗癫痫药物，其中很大一部分患者接受了多种药物治疗。该结果为旨在识别干预点和改善癫痫囚犯医疗保健的前瞻性研究提供了一个起点。
囚犯是癫痫患者中一个脆弱的群体。与一般人群相比，他们存在显著差异，尤其是精神科合并症更多，癫痫发作控制更差，这主要是由于难以获得医疗保健、抗癫痫药物和诊断测试。我们发现，最具特征性的人群是 40 多岁的男性，癫痫发作频率高，大多数患者正在接受多种抗癫痫药物治疗。这项研究是拉丁美洲首例此类研究，是对囚犯癫痫的初步研究。
