Subject(s)
Coronavirus Infections/epidemiology , Coronavirus , Pandemics , Pneumonia, Viral/epidemiology , Betacoronavirus , COVID-19 , China , Humans , SARS-CoV-2ABSTRACT
OBJECTIVES: To describe the sociodemographic and clinical characteristics of a cohort of patients with epilepsy from a reference centre in Colombia. METHODS: Cross-sectional study including patients diagnosed with epilepsy who attended our epilepsy centre (Neurocentro) between 2013 and 2016. Data were gathered from patients' medical histories. RESULTS: We gathered data from a total of 354 patients diagnosed with epilepsy. Median age was 37 years; 52% were men. Seizures were focal in 57% of the patients and generalised in 38%; seizure type was not determined in 6% of the sample. The most frequent aetiology was cryptogenic (21%), followed by traumatic (14%). Median time of disease progression and age at onset were 23 and 11 years, respectively. Psychiatric comorbidities were found in 18% of the patients and 40% had some degree of cognitive impairment. Around 40% of our sample reported adverse reactions to antiepileptic drugs at some point during treatment. Antiepileptic drugs were administered in monotherapy in 36% of the patients. Around 37% had drug-resistant epilepsy and 14% underwent surgery. CONCLUSIONS: Psychiatric comorbidities, cognitive impairment, adverse drug reactions, and drug-resistant epilepsy are common among epileptic patients in Colombia. Knowledge of the factors with an impact on epilepsy may lay the foundations for improving management of these patients on the administrative level and improving quality of life.
Subject(s)
Epilepsy , Adult , Colombia , Cross-Sectional Studies , Demography , Epilepsy/complications , Epilepsy/diagnosis , Epilepsy/drug therapy , Female , Humans , Male , Middle Aged , Sociological FactorsABSTRACT
INTRODUCTION: Selected patients with drug-resistant focal epilepsy benefit from epilepsy surgery, however significant delays remain. The aim of this study was to assess knowledge and attitudes toward epilepsy surgery among patients with epilepsy and identify barriers that might delay the treatment. PATIENTS AND METHODS: A 10-minute questionnaire was administered to patients with epilepsy in Colombia. Survey assessed the following: knowledge of surgical options, perceptions about the risks of surgery vs. ongoing seizures, disease disability, treatment goals, and demographic and socioeconomic variables. RESULTS: We recruited 88 patients with focal epilepsy. More than half of patients (56%) were not aware that surgery might be an option. Apprehension about epilepsy surgery was evident, 60% of patients perceived epilepsy surgery to be very or moderately dangerous. A large proportion of patients believe death (41%), stroke (47%), vision loss (56%), personality change (56%), paralysis (62%), difficulties in speaking (69%), and memory loss (60%) were frequent side effects. The majority of patients (62%) consider the surgical procedure as the last option of treatment. CONCLUSIONS: There is a negative attitude toward epilepsy surgery based on the patients' misperceptions of suffering neurological deficits during the surgery, reflecting lack of knowledge toward this type of treatment. These perceptions can contribute to delays in surgical care.
TITLE: Percepciones y actitudes de los pacientes frente a la cirugia de la epilepsia: conceptos equivocados en Colombia.Introduccion. Los pacientes con epilepsia focal farmacorresistente se podrian beneficiar de la cirugia de la epilepsia; sin embargo, existen demoras en la realizacion del procedimiento. El objetivo de este estudio fue evaluar el conocimiento y las actitudes de los pacientes hacia la cirugia de epilepsia e identificar barreras que pudieran retrasar el tratamiento. Pacientes y metodos. Se aplico un cuestionario de 10 minutos a pacientes con epilepsia en Colombia. La encuesta evaluo el conocimiento de la opcion quirurgica, las percepciones sobre el riesgo de la cirugia frente al riesgo de crisis no controladas, la discapacidad producida por la enfermedad, las metas del tratamiento y las variables demograficas y socioeconomicas. Resultados. Se seleccionaron 88 pacientes con epilepsia focal. El 56% de los pacientes no sabia que la cirugia podria ser una opcion terapeutica. El 60% considero que la cirugia de la epilepsia es muy o moderadamente peligrosa. Una gran proporcion pensaba que la muerte (41%), el ictus (47%), la perdida visual (56%), los cambios en la personalidad (56%), la paralisis (61%), las dificultades para hablar (69%) y la perdida de la memoria (60%) eran efectos secundarios comunes. La mayoria (62%) consideraba el procedimiento como la ultima opcion de tratamiento. Conclusiones. Existe una actitud negativa por parte de los pacientes frente a la cirugia de la epilepsia fundamentada en la sobreestimacion del riesgo de adquirir deficits neurologicos secundarios al procedimiento, lo que refleja la falta de conocimiento hacia este tratamiento. Estas percepciones erroneas pueden contribuir a demoras en la atencion quirurgica.
Subject(s)
Attitude to Health , Drug Resistant Epilepsy/psychology , Epilepsies, Partial/psychology , Epilepsy/surgery , Neurosurgical Procedures/psychology , Patients/psychology , Therapeutic Misconception , Adolescent , Adult , Aged , Aged, 80 and over , Colombia , Cross-Sectional Studies , Educational Status , Fear , Female , Humans , Income , Male , Middle Aged , Pilot Projects , Postoperative Complications/psychology , Socioeconomic Factors , Surveys and Questionnaires , Young AdultABSTRACT
AIM: To identify predictors of seizure related injuries in adult patients with epilepsy in Colombia. SUBJECTS AND METHODS: Case-control study. Patients with a diagnosis of epilepsy aged 16 years and older who attended the Neurocentro epilepsy center between 2013-2016 and were attended by a specialist in epilepsy were included. Patients with seizure related injuries were defined as the case. The control group was conformed by those without seizure related injuries. Odds ratios and 95% confidence intervals were calculated. A logistic regression was performed. RESULTS: A total of 101 (28.5%) patients were cases and 253 (71.5%) were controls. Patients with seizure related injuries were significantly younger than controls at the age of onset of epilepsy (9 vs 12 years; p = 0.017). The significant variables in the bivariate analysis were: some degree of cognitive impairment, drug resistant epilepsy, abnormal neurological examination, and seizures related with changes in the lunar phases. No protective factors were identified. In the multivariate analysis, two variables remained significant: drug resistant epilepsy and some degree of cognitive impairment. CONCLUSION: Drug-resistant epilepsy and cognitive impairment were predictors of seizure related injuries in adult patients with epilepsy. Adequate pharmacological control of epileptic seizures and prevention recommendations may reduce the risk of seizure related injuries in these patients.
TITLE: Predictores de lesiones asociadas a crisis epilepticas en pacientes adultos con epilepsia en Colombia: estudio de casos y controles.Objetivo. Identificar los predictores de lesiones asociadas con crisis epilepticas en adultos con epilepsia en Colombia. Sujetos y metodos. Estudio de casos y controles. Se incluyo a los pacientes con diagnostico de epilepsia mayores de 16 anos que fueron atendidos por una especialista en epilepsia que acudieron a Neurocentro en el periodo comprendido entre 2013 y 2016. Se definio como caso a los pacientes que habian presentado lesiones asociadas con crisis epilepticas, y como grupo control, a los que no las habian presentado. Se calcularon odds ratios e intervalos de confianza al 95%. Se realizo una regresion logistica. Resultados. Se identificaron 101 (28,5%) casos y 253 (71,5%) controles. Los pacientes con lesiones asociadas con crisis epilepticas fueron significativamente mas jovenes que los controles a la edad de inicio de la epilepsia (9 frente a 12 anos; p = 0,017). Las variables significativas en el analisis bivariado fueron: algun grado de deterioro cognitivo, epilepsia resistente a medicamentos, examen neurologico anormal y crisis asociadas a cambios en las fases lunares. No se identificaron factores protectores. En el analisis multivariado, dos variables permanecieron significativas: epilepsia resistente a medicamentos y algun grado de deterioro cognitivo. Conclusion. Se observo que la epilepsia resistente a medicamentos y el deterioro cognitivo son predictores de lesiones asociadas con crisis epilepticas en pacientes adultos con epilepsia. Un adecuado control farmacologico de las crisis epilepticas y unas recomendaciones de prevencion pueden disminuir el riesgo de dichas lesiones en estos pacientes.
