Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America
There are limited data on first seizure (FS) among adults in low and middle-income countries. We describe findings from a prospective cohort study involving 180 adults presenting with seizures in emergency departments in five Latin American countries. Overall, 102 participants (56.7%) had acute symp...
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| Format: | ARTÍCULO |
| Language: | es_ES |
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2024
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| Online Access: | http://dspace.ucuenca.edu.ec/handle/123456789/44037 https://www.scopus.com/record/display.uri?eid=2-s2.0-85185695350&doi=10.1002%2fepi4.12900&origin=inward&txGid=fe1c6819b0bac384f4053ce8cb98b906 |
| _version_ | 1793400622088716288 |
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| author | Carpio Rodas, Luis Arturo |
| author_facet | Carpio Rodas, Luis Arturo |
| author_sort | Carpio Rodas, Luis Arturo |
| collection | DSpace |
| description | There are limited data on first seizure (FS) among adults in low and middle-income countries. We describe findings from a prospective cohort study involving 180 adults presenting with seizures in emergency departments in five Latin American countries. Overall, 102 participants (56.7%) had acute symptomatic seizures (ASyS) while 78 (43.3%) had unprovoked seizures (UPS). Among patients with ASyS, 55 (53.9%) had structural causes, with stroke (n = 24, 23.5%), tumor (n = 10, 9.8%), and trauma (n = 3, 3%) being the most frequent. Nineteen patients (18.6%) had infectious causes, including four (4%) with meningoencephalitis, three (3%) neurocysticercosis, and two (2%) bacterial meningoencephalitis. Twenty patients (19.6%) had metabolic/toxic evidence, including four (4%) with uremic encephalopathy, two (2%) hyponatremia, and three (3%) acute alcohol intoxication. Immune dysfunction was present in seven (7%) patients and neurodegenerative in two (2%). Among participants with UPS, 45 (57.7%) had unknown etiology, 24 (30.7%) had evidence of structural disorders (remote symptomatic), four (5%) were related to infectious etiology (>7 days before the seizure), and five (6.4%) had genetic causes. During the 3- and 6-month follow-up, 29.8% and 14% of patients with UPS, respectively, experienced seizure recurrence, while 23.9% and 24.5% of patients with ASyS had seizure recurrence. Longer follow-up is necessary to assess seizure recurrence for patients with ASyS after the acute cause is resolved and to determine the 10-year risk of recurrence, which is part of the definition of epilepsy. Plain Language Summary: We monitored 180 adults who presented with their first seizure in emergency departments across five Latin American countries. Among these patients, 57% had acute symptomatic seizures, with structural causes such as stroke (23%), infection (17%), or tumor (10%) being more prevalent. Among the 43% with unprovoked seizures, 58% showed no identifiable acute cause, while 6.4% were due to genetics. Within 3 months after their initial seizure, 26.6% of individuals experienced a second seizure, with 11.9% continuing to have seizures in Months 3–6. Between Months 3 and 6, an additional 20% of patients encountered a second seizure. Research is needed to better understand the cause and prognosis of these patients to improve outcomes. |
| format | ARTÍCULO |
| id | oai:dspace.ucuenca.edu.ec:123456789-44037 |
| institution | Universidad de Cuenca |
| language | es_ES |
| publishDate | 2024 |
| record_format | dspace |
| spelling | oai:dspace.ucuenca.edu.ec:123456789-440372024-03-04T20:13:25Z Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America Carpio Rodas, Luis Arturo Acute symptomatic seizures First seizure Etiology Epilepsy Neurocysticercosis There are limited data on first seizure (FS) among adults in low and middle-income countries. We describe findings from a prospective cohort study involving 180 adults presenting with seizures in emergency departments in five Latin American countries. Overall, 102 participants (56.7%) had acute symptomatic seizures (ASyS) while 78 (43.3%) had unprovoked seizures (UPS). Among patients with ASyS, 55 (53.9%) had structural causes, with stroke (n = 24, 23.5%), tumor (n = 10, 9.8%), and trauma (n = 3, 3%) being the most frequent. Nineteen patients (18.6%) had infectious causes, including four (4%) with meningoencephalitis, three (3%) neurocysticercosis, and two (2%) bacterial meningoencephalitis. Twenty patients (19.6%) had metabolic/toxic evidence, including four (4%) with uremic encephalopathy, two (2%) hyponatremia, and three (3%) acute alcohol intoxication. Immune dysfunction was present in seven (7%) patients and neurodegenerative in two (2%). Among participants with UPS, 45 (57.7%) had unknown etiology, 24 (30.7%) had evidence of structural disorders (remote symptomatic), four (5%) were related to infectious etiology (>7 days before the seizure), and five (6.4%) had genetic causes. During the 3- and 6-month follow-up, 29.8% and 14% of patients with UPS, respectively, experienced seizure recurrence, while 23.9% and 24.5% of patients with ASyS had seizure recurrence. Longer follow-up is necessary to assess seizure recurrence for patients with ASyS after the acute cause is resolved and to determine the 10-year risk of recurrence, which is part of the definition of epilepsy. Plain Language Summary: We monitored 180 adults who presented with their first seizure in emergency departments across five Latin American countries. Among these patients, 57% had acute symptomatic seizures, with structural causes such as stroke (23%), infection (17%), or tumor (10%) being more prevalent. Among the 43% with unprovoked seizures, 58% showed no identifiable acute cause, while 6.4% were due to genetics. Within 3 months after their initial seizure, 26.6% of individuals experienced a second seizure, with 11.9% continuing to have seizures in Months 3–6. Between Months 3 and 6, an additional 20% of patients encountered a second seizure. Research is needed to better understand the cause and prognosis of these patients to improve outcomes. 2024-03-04T20:13:21Z 2024-03-04T20:13:21Z 2024 ARTÍCULO 2470-9239 http://dspace.ucuenca.edu.ec/handle/123456789/44037 https://www.scopus.com/record/display.uri?eid=2-s2.0-85185695350&doi=10.1002%2fepi4.12900&origin=inward&txGid=fe1c6819b0bac384f4053ce8cb98b906 10.1002/epi4.12900 es_ES application/pdf Epilepsia Open |
| spellingShingle | Acute symptomatic seizures First seizure Etiology Epilepsy Neurocysticercosis Carpio Rodas, Luis Arturo Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America |
| title | Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America |
| title_full | Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America |
| title_fullStr | Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America |
| title_full_unstemmed | Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America |
| title_short | Causes and prognosis of adults experiencing a first seizure in adulthood: A pilot cohort study conducted in five countries in Latin America |
| title_sort | causes and prognosis of adults experiencing a first seizure in adulthood: a pilot cohort study conducted in five countries in latin america |
| topic | Acute symptomatic seizures First seizure Etiology Epilepsy Neurocysticercosis |
| url | http://dspace.ucuenca.edu.ec/handle/123456789/44037 https://www.scopus.com/record/display.uri?eid=2-s2.0-85185695350&doi=10.1002%2fepi4.12900&origin=inward&txGid=fe1c6819b0bac384f4053ce8cb98b906 |
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