Clinical and demografhical characteristics of people with epileptic crisis coming from a cysticercoses and taeniasis endemic area in Bahia state

THESES

Clinical and demografhical characteristics of people with epileptic crisis coming from a cysticercoses and taeniasis endemic area in Bahia state (Abstract)^*. Dissertation. Salvador, 2003

Emília Katiane Embiruçu

^{Correspondence}

Epilepsy is frequent all over the world, occurring independent of gender, age, race or social status. The highest prevalence rates occur in countries under development and are due to infectious parasitic diseases, like cysticercosis. Neurocysticercosis is the main cause of secondary epilepsy in the world because of its high prevalence in regions with precarious sanitary infrastructure. The study of epileptic crisis in poor communities, with inadequate medical care and poor access to medication, allowed the analysis of a clinical evolution close to the disease´s natural history. Besides, it represents the local community´s reality and eliminates selection bias, different from studies conducted in reference centers.

OBJECTIVE: To determinate the prevalence of epilepsy and to describe the clinical and demografhical characteristics of people with seizures in the city of Mulungu do Morro, Bahia State, Brazil, an endemic area for cysticercosis (1.6%) and taeniasis (4.5%).

STUDY DESIGN: 1. transversal cut for prevalence determination and 2. prospective cohort.

METHOD: Firstly, it was performed the health agents training for knowing the epileptic crisis trial questionnaire, and then these questionnaires were applied in a sample of the local population. The individuals suspected of seizures and 10% of the negative sample were evaluated by the group neurologists. At the same time, people with clinical picture suggestive of epilepsy were convoked by the region´s radio system. All the epileptic individuals identified in the population or convoked were accompanied in the reference ambulatory installed in the city of Mulungu do Morro for this purpose. The patients formed two groups; those who came from the community and those from the ambulatory. The data were inserted in an ACCESS 2000 bank and analyzed with the statistic program SPSS version 6.0. It was considered 95%confidence limits and employed the Z, qui-square and Fisher tests, according to the variables analyzed.

RESULTS: 456 families were evaluated , making a total of 2138 individuals. The prevalence of active epilepsy was 6.2 / 1000 and accumulated, including single seizure, 22.9 / 1000. It was not observed variation between genders. The most affected ages were from 11 to 30 years (75%). The majority (75%) of the seizures begun before the ages of 25. Comparing the results from both groups (community and ambulatory) there was no differences related to gender, age or beginning of the crises. In both it was observed a predominance of one kind of seizure and of partial and secondary generalized crisis. Among the patients who came from the community there were more frequent single seizure or with long periods between crises, more recent crises, inactive epilepsy and a greater number of patients not using any kind of anti-epileptic drug.

CONCLUSION: In Mulungu do Morro epilepsy presents high prevalence, occurring among all ages and with a higher frequency of start in childhood and adolescence. The seizures from the community´s patients tend to occur in the isolated or recurrent form with long periods between them, the highest numbers of cases are found in the inactive form and without the use of medication. The patients who looked for the ambulatory have a worse prognosis because they present seizures more frequently and usually are using medication.

Key words: epilepsy, epileptic crisis, prevalence, cysticercosis.

*

Características clínicas e demográficas de indivíduos com crises epilépticas em uma área endêmica para cisticercose e teníase no Estado da Bahia (Resumo). Dissertação de Mestrado, Universidade Federal da Bahia (Área: Neurociências). Orientador: Ailton Melo.

Publication Dates

• Publication in this collection
  25 Apr 2006
• Date of issue
  Dec 2004