RESUMO
INTRODUCTION: Epileptic seizures are a common complication among patients who are admitted to rehabilitation hospitals. This work examines aspects related to their aetiology and progress. PATIENTS AND METHODS: The study involved all the patients with a history of epileptic seizures who had been consecutively admitted for rehabilitation during the second semester of 2008. The protocol for data collection included sociodemographic variables, the aetiology, type, frequency and complications of the seizures, and their treatment and side effects. RESULTS: An analysis was performed on 160 patients (62.5% males; mean age: 43.6 years). The main aetiologies were the following: stroke (41.2%), traumatic brain injury (35%), meningitis/encephalitis (5%), primary brain tumour (3.8%), anoxia (3.8%), static encephalopathy (3.8%) and others (7.6%). 7.6% had a history of epilepsy before suffering the brain injury. 16.3% had had a single epileptic seizure. 6.2% presented treatment failure with two antiepileptic drugs, and 12.5% suffered from more than one seizure per month. 17.5% of the patients had suffered from an epileptic status. In semiological terms, the most common seizures were focal seizures (54.5%), generalised seizures (44.4%) and focal seizures with secondary generalisation (31.9%). 76% of the subjects took antiepileptic drugs on a regular basis, but the caregiver was responsible for medication in 70% of cases. Carbamazepine and valproate were the two most frequently used drugs. CONCLUSIONS: Epilepsy can limit rehabilitation therapy in patients with stroke or traumatic injury, due to the risk of developing difficult-to-treat epilepsy. Caregivers often have to take responsibility for the pharmacological treatment in disabled patients with brain damage.
Assuntos
Lesões Encefálicas , Epilepsia/etiologia , Centros de Reabilitação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticonvulsivantes/uso terapêutico , Lesões Encefálicas/complicações , Lesões Encefálicas/reabilitação , Carbamazepina/uso terapêutico , Epilepsia/tratamento farmacológico , Epilepsia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ácido Valproico/uso terapêutico , Adulto JovemRESUMO
The aim of this study was to investigate the prevalence of patent foramen ovale (PFO) in a consecutive unselected cohort of migraine patients (with and without aura) and compare it with a group of ischaemic young and elderly stroke patients. One hundred and forty-one migraine patients were compared with 330 stroke patients (130 young patients; 200 elderly patients) selected from our hospital stroke data bank. PFO was assessed with transcranial Doppler sonography with i.v. injection of agitated saline. The prevalence of PFO was 51.7% in migraine with aura (MA) patients, 33.7% in migraine without aura (MoA) patients, 33.8% in young stroke patients and 20.5% in elderly stroke patients (P < 0.001). The prevalence of PFO in cryptogenic stroke in young and elderly stroke patients was, respectively, 41.1% and 25% (P = 0.04). The difference between MA and MoA patients was significant (odds ratio = 2.1). The prevalence of PFO in MA patients is higher than in MoA patients and in young cryptogenic stroke patients.