Patients with refractory epilepsy in a 4th level colombian hospital. Descriptive study

Abstract

Introduction. Description of epileptic syndromes in our environment represents an important tool to the therapeutical approach. We show principal dates related to pediatric population with refractory epilepsy in our medical institution according to clinical associated factors, clinical findings and therapeutical answer. 

Objective. Clinical and demographic characterization of a group of patients with diagnostic criteria of refractory epilepsy in a fourth level Colombian hospital. 

Materials and methods. In the fundación hospital de la misericordia between january 2005 and august 2007 we reviewed 210 clinical records of patients attended in the emergency room with diagnostic criteria of refractory epilepsy.
Results. Most of the patients were infants from Bogotá. Principals pathologies related to this nature of epileptic syndrome were premature delivery, fetal distress, hypoglycemia and meningeal infection. There was a high rate of children with psychomotor delay and family history of epilepsy. First crisis was documented before 20 months age as a complex seizure, being part of symptomatic epilepsy. Carbamazepine was the most prescribed anti epileptic drug. Electroencephalogram and magnetic resonance image made evident temporal lobe as the most compromised anatomical region.
28 Patients with temporal lobe focus were taken to surgery with temporal lobectomy and hippocampus resection. 90% of patients achieved total seizures control, 10% remaining continued equally.
Conclusion. According to these results infancy was the principal age to diagnose refractory epilepsy. Family history and perinatal morbidities were the principal factors in relation to this diagnosis. Surgical intervention of temporal lobe showed acceptable results.