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Pediatric epilepsy surgery and sudden unexpected death epilepsy: the contribution of a Brazilian epilepsy surgery program.
Terra, Vera C; Scorza, Fulvio A; Cavalheiro, Esper A; Wichert-Ana, Lauro; Pinto, Kylvia G F D; Machado, Helio R; Sakamoto, Américo C.
Afiliação
  • Terra VC; Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Centro de Cirurgia de Epilepsia, Ribeirão Preto, São Paulo, Brazil. v.c.terra@rnp.fmrp.usp.br
Childs Nerv Syst ; 26(8): 1075-9, 2010 Aug.
Article em En | MEDLINE | ID: mdl-20195616
BACKGROUND AND PURPOSE: Individuals with epilepsy are at higher risk of death than those from the general population, and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Epilepsies in the pediatric group are more frequently associated with known potentially risk factors for SUDEP, and a treatment resulting in an improved seizure control may also decrease mortality. The aim of this study is to identify the incidence of SUDEP in a group of operated-on children and adolescents. METHODS: We analyzed 267 patients up to 18 years old, with medically intractable epilepsy submitted to surgery. We considered the age at surgery, the seizure type, the pathological findings, and the seizure outcome. Data were prospectively collected, according to the protocols of our institution's ethics committee. RESULTS: The percentage of boys was 58.05. A good outcome was achieved in 72.6% of the cases and a bad outcome in 27.4%. Nine patients died during follow-up, six from clinical complications, and one from SUDEP. All patients who died during the long-term follow-up had persisted with refractory postoperative seizures. The patient who died from SUDEP died during a generalized tonic-clonic seizure. CONCLUSIONS: Of the patients, 72.6% had excellent postoperative outcome, and one patient died of SUDEP. All patients who died had had disabling seizures' persistence. The surgical treatment of epilepsy in children and adolescents is an efficient therapy for the medically intractable symptomatic epilepsies and also for the reduction of mortality and SUDEP risks.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Morte Súbita / Epilepsia Tipo de estudo: Guideline / Incidence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Ethics Limite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Childs Nerv Syst Assunto da revista: NEUROLOGIA / PEDIATRIA Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Morte Súbita / Epilepsia Tipo de estudo: Guideline / Incidence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Ethics Limite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Childs Nerv Syst Assunto da revista: NEUROLOGIA / PEDIATRIA Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha