Abstracts

Introduction: 150,000 adults have a first seizure a year, of which 40 to 50% develop epilepsy. Seizures are triggered by epilepsy, tumors, stroke, vasculitis, metabolic or infectious diseases. Is essential a complete medical history, clinical examination and screening studies for the differential diagnosis. Objectives: To describe the epidemiology, clinical and screening studies of adults with a first seizure. Method: 1-year retrospective study that compiled demographic, clinical and screening studies for these patients. Results: 24 patients, 60% female, mean age 41 18 years. Background: cardiovascular diseases (25%), Diabetes mellitus (21%), head trauma (17%), alcoholism (17%), Eritematous Systemic Lupus (12%), renal failure (8%), syncope (4%) and family history of epilepsy (3%). Nobody had history of febrile seizures. Generalized seizures occurred in 54%. Seizures duration: 3.6 2 min. One patient had status epilepticus (SE). Clinical manifestations: motor (67%), unresponsiveness (46%), sensory (17%), loss of consciousness (8%), psychiatric (8%), dizziness 8% and blurred vision (4%). The neurological examination was abnormal in 29%: 17% had manifestations of Parkinson disease, Stroke or peripheral neuropathy. The etiology was: symptomatic remote (46%), symptomatic acute (37%) and cryptogenic (17%)]. Etiology of symptomatic remote was: Stroke (25%), neuroinfections 12% (Toxoplasmosis, neurocysticercosis and meningoencephalitis), systemic infections (4%), neuroglial cyst (4%), vascular malformation (4%), cerebral hemorrhage (4%), brain abscess (4%) and vasculitis (4%). The imaging study (IS) was performed in 96% 74% was abnormal: focal lesions (56%), diffuse lesions (13%) and unspecified (4%). The EEG was abnormal in 67%: focal epileptiform activity (33%), generalized slowing (16%), focal slowing (12%) and nonspecific findings (4%). Discussion and conclusion: There were more seizures in middle-aged woman. The main backgrounds were: chronic degenerative diseases, head trauma and alcoholism. Family history of epilepsy was low. Generalized seizures lasting < 5 min were predominant. The main manifestations were motor and unresponsiveness. Most were symptomatic possibly because our hospital is a reference center, and the main origins were stroke and neuroinfections. Neurological examination was abnormal in 33%. The incidence of SE was low. Abnormalities in IS were higher when compared to 10% reported in literature. The main abnormality was focal lesion. EEG presented a high percentage of abnormalities compared to 23% reported by other authors and the main activity was the focal epileptiform.