ABSTRACT
Introducción El síndrome de pseudotumor cerebri (SPTC) en pacientes prepuberales presenta características que lo diferencian respecto a su presentación en la etapa pospuberal. Nuestro objetivo es describir las características de los pacientes diagnosticados de SPTC pediátrico en nuestro centro y compararlas en función de su estado puberal. Pacientes y métodos Se incluyeron a los pacientes diagnosticados de SPTC en un hospital de tercer nivel entre los años 2006 y 2019 con edades comprendidas entre uno y 18 años que cumplieran los criterios diagnósticos actualizados del SPTC. Se clasificaron en función de su estado puberal y peso corporal. Posteriormente, se analizaron los datos de las punciones lumbares, estudios de neuroimagen, valoraciones oftalmológicas, así como el régimen terapéutico recibido a lo largo de su seguimiento. Resultados Se recogieron 28 pacientes, 22 prepuberales y seis pospuberales, con edad media de 9,04 ± 2,86 años. El 83,3% de los pacientes pospuberales eran varones presentando sobrepeso/obesidad en el 66,7%. Eran varones el 27% de los pacientes prepuberales, de ellos asociaban sobrepeso el 31,8%. La sintomatología más frecuente fue cefalea (89,9%) y visión borrosa (42,9%). Todos los pacientes presentaron papiledema; un 21,4% de los casos presentaron parálisis del VI par. Se identificó un posible desencadenante en un 28,6%. El 19% presentaron recurrencia clínica, siendo todos ellos prepuberales. La resolución clínica completa se produjo en el 55,6% de los pacientes. Conclusión Pacientes con SPTC presentan menor prevalencia de obesidad en la etapa prepuberal, junto con un mayor porcentaje de etiologías secundarias y tasa de recurrencia que los pacientes pospuberales. (AU)
Introduction Pseudotumor cerebri (PC) in prepubertal patients displays certain characteristics that differentiate it from its presentation at the postpubertal stage. The aim of this study is to describe the characteristics of paediatric patients diagnosed with PC at our centre and to compare them according to their pubertal status. Patients and methods We included patients aged between 1 and 18 years who were diagnosed with PC in a tertiary-level hospital between 2006 and 2019 and who met the updated diagnostic criteria for PC. They were classified according to body weight and pubertal status. Subsequently, we analysed results from lumbar punctures, neuroimaging studies, ophthalmological assessments, and treatments received during follow-up. Results We included 28 patients, of whom 22 were of prepubertal age and 6 were of postpubertal age. The mean age (standard deviation) was 9.04 (2.86) years. Among the postpubertal patients, 83.3% were boys, 66.7% of whom presented overweight/obesity. In the group of prepubertal patients, 27% were boys, 31.8% of whom were overweight. The most frequent symptoms were headache (89.9%) and blurred vision (42.9%). All patients presented papilloedema, and 21.4% manifested sixth nerve palsy. Possible triggers were identified in 28.6% of cases. Nineteen percent of patients presented clinical recurrence, all of whom were prepubertal patients. Complete clinical resolution was achieved in 55.6% of patients. Conclusion Prepubertal patients with PC show lower prevalence of obesity, higher prevalence of secondary aetiologies, and higher recurrence rates than postpubertal patients. (AU)
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Pseudotumor Cerebri , Obesity , Puberty , Longitudinal Studies , Retrospective StudiesABSTRACT
INTRODUCTION: Pseudotumor cerebri (PC) in prepubertal patients displays certain characteristics that differentiate it from its presentation at the postpubertal stage. The aim of this study is to describe the characteristics of paediatric patients diagnosed with PC at our centre and to compare them according to their pubertal status. PATIENTS AND METHODS: We included patients aged between 1 and 18 years who were diagnosed with PC in a tertiary-level hospital between 2006 and 2019 and who met the updated diagnostic criteria for PC. They were classified according to body weight and pubertal status. Subsequently, we analysed results from lumbar punctures, neuroimaging studies, ophthalmological assessments, and treatments received during follow-up. RESULTS: We included 28 patients, of whom 22 were of prepubertal age and 6 were of postpubertal age. The mean age (standard deviation) was 9.04 (2.86) years. Among the postpubertal patients, 83.3% were boys, 66.7% of whom presented overweight/obesity. In the group of prepubertal patients, 27% were boys, 31.8% of whom were overweight. The most frequent symptoms were headache (89.9%) and blurred vision (42.9%). All patients presented papilloedema, and 21.4% manifested sixth nerve palsy. Possible triggers were identified in 28.6% of cases. Nineteen percent of patients presented clinical recurrence, all of whom were prepubertal patients. Complete clinical resolution was achieved in 55.6% of patients. CONCLUSION: Prepubertal patients with PC show lower prevalence of obesity, higher prevalence of secondary aetiologies, and higher recurrence rates than postpubertal patients.
Subject(s)
Pseudotumor Cerebri , Male , Humans , Child , Infant , Child, Preschool , Adolescent , Female , Pseudotumor Cerebri/diagnosis , Pseudotumor Cerebri/epidemiology , Overweight/complications , Retrospective Studies , Prognosis , Obesity/complicationsABSTRACT
INTRODUCTION: Pseudotumor cerebri (PC) in prepubertal patients displays certain characteristics that differentiate it from its presentation at the postpubertal stage. The aim of this study is to describe the characteristics of paediatric patients diagnosed with PC at our centre and to compare them according to their pubertal status. PATIENTS AND METHODS: We included patients aged between 1 and 18 years who were diagnosed with PC in a tertiary-level hospital between 2006 and 2019 and who met the updated diagnostic criteria for PC. They were classified according to body weight and pubertal status. Subsequently, we analysed results from lumbar punctures, neuroimaging studies, ophthalmological assessments, and treatments received during follow-up. RESULTS: We included 28 patients, of whom 22 were of prepubertal age and 6 were of postpubertal age. The mean age (standard deviation) was 9.04 (2.86) years. Among the postpubertal patients, 83.3% were boys, 66.7% of whom presented overweight/obesity. In the group of prepubertal patients, 27% were boys, 31.8% of whom were overweight. The most frequent symptoms were headache (89.9%) and blurred vision (42.9%). All patients presented papilloedema, and 21.4% manifested sixth nerve palsy. Possible triggers were identified in 28.6% of cases. Nineteen percent of patients presented clinical recurrence, all of whom were prepubertal patients. Complete clinical resolution was achieved in 55.6% of patients. CONCLUSION: Prepubertal patients with PC show lower prevalence of obesity, higher prevalence of secondary aetiologies, and higher recurrence rates than postpubertal patients.
ABSTRACT
TITLE: Neuropatia craneal multiple: descripcion de tres pacientes pediatricos.
Subject(s)
Cranial Nerve Diseases/diagnosis , Child , Female , Humans , MaleABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Child , Cranial Nerve Diseases/diagnostic imaging , Cranial Nerve Diseases/drug therapy , Ophthalmoplegia/complications , Adrenal Cortex Hormones/therapeutic use , Pseudotumor Cerebri/diagnostic imaging , Guillain-Barre Syndrome/diagnosis , Diagnosis, Differential , Neuroimaging/methods , Visual AcuityABSTRACT
TITLE: Microcefalia primaria hereditaria de tipo 5. No todo es virus del Zika.
Subject(s)
Microcephaly/diagnosis , Diagnosis, Differential , Humans , Infant, Newborn , Male , Zika Virus Infection/diagnosisABSTRACT
Introducción: Las complicaciones neurológicas (CN) suponen una parte importante de la morbimortalidad del postoperatorio del trasplante pediátrico de órgano sólido (TPOS).El objetivo fue exponer la experiencia de nuestro hospital, un centro de referencia de trasplante pediátrico cardiaco, hepático y pulmonar. Pacientes y métodos: Estudio descriptivo retrospectivo de 140 pacientes receptores de TPOS en el periodo 2000-2011. Resultados: Presentaron CN 23 pacientes receptores de TPOS (16,4% de casos), con una mediana de edad de 6 años. Las sintomatologías más frecuentes fueron: crisis epilépticas sintomáticas agudas (12 pacientes) y encefalopatía aguda (11 pacientes), seguidas por debilidad neuromuscular (4 niños), temblor (4 niños), cefalea (2 niños), dolor neuropático (2 niños) y alteraciones visuales (2 niños). Las principales etiologías de las CN fueron: neurotoxicidad de los inmunosupresores (12 casos), hipoxia-isquemia cerebral (6 casos), infecciones (2 casos), compresión mecánica de nervio periférico durante la cirugía (2 casos) y trastorno metabólico (un caso). Cinco pacientes presentaron síndrome de encefalopatía posterior reversible (SEPR). Fallecieron 7 pacientes, 4 por encefalopatía hipóxico-isquémica grave. Los pacientes con SEPR evolucionaron favorablemente. Conclusiones: Las CN que se presentan en el postoperatorio del TPOS tienen una incidencia considerable, siendo las crisis epilépticas y la encefalopatía aguda las manifestaciones más comunes. No encontramos diferencia de CN en los diferentes tipos de trasplante. La neurotoxicidad de los inmunosupresores y la hipoxia-isquemia cerebral son las principales causas de CN, teniendo un manejo y evolución diferentes. El pronóstico en la mayoría de casos es favorable, salvo en los afectados por encefalopatía hipóxico-isquémica moderada o grave(AU)
Introduction: Neurological complications (NC) are a significant cause of morbidity and mortality in paediatric patients receiving solid organ transplants. Our aim was to describe the experience of our hospital with NC in paediatric patients receiving heart, lung and liver transplants. Patients and methods: A retrospective study was conducted on 140 paediatric patients who received a solid organ transplant during the period 2000-2011. Results: A total of 23 paediatric solid organ transplant recipients (16.4% of cases), with a median age of 6 years, had NC. The symptoms were, in order of frequency: acute symptomatic seizures (12 patients); acute encephalopathy (11 patients); neuromuscular weakness (4 children), tremor (4 children), headache (2 children), neuropathic pain (2 children), and visual disturbances (2 children). The aetiologies of NC were: the neurotoxicity of the immunosuppressive drugs (12 patients), post-hypoxic-ischaemic encephalopathy (6 patients), infections (2 cases), mechanical compression of peripheral nerve during surgery (2 cases), and a metabolic complication (1 case). The five patients who met the criteria of posterior reversible encephalopathy syndrome had a favourable outcome. Seven patients died, four of them due to hypoxic-ischaemic encephalopathy. Conclusions: NC are common in paediatric patients receiving heart, liver, lung, and renal transplants, with acute symptomatic seizures and acute encephalopathy being the most common clinical signs. No differences were found in the NC with the different types of transplants. Neurotoxicity of the immunosuppressive drugs and hypoxic-ischaemic encephalopathy were the main causes of NC, having different management and outcomes. The prognosis was favourable in most of the patients, except for those who had moderate or severe post-hypoxic-ischaemic damage(AU)
Subject(s)
Humans , Transplantation/adverse effects , Nervous System Diseases/etiology , Retrospective Studies , Epilepsy/epidemiology , Brain Diseases/epidemiology , Immunosuppressive Agents/adverse effects , Tacrolimus/adverse effects , Neuromuscular Diseases/etiologyABSTRACT
INTRODUCTION: Neurological complications (NC) are a significant cause of morbidity and mortality in paediatric patients receiving solid organ transplants. Our aim was to describe the experience of our hospital with NC in paediatric patients receiving heart, lung and liver transplants. PATIENTS AND METHODS: A retrospective study was conducted on 140 paediatric patients who received a solid organ transplant during the period 2000-2011. RESULTS: A total of 23 paediatric solid organ transplant recipients (16.4% of cases), with a median age of 6 years, had NC. The symptoms were, in order of frequency: acute symptomatic seizures (12 patients); acute encephalopathy (11 patients); neuromuscular weakness (4 children), tremor (4 children), headache (2 children), neuropathic pain (2 children), and visual disturbances (2 children). The aetiologies of NC were: the neurotoxicity of the immunosuppressive drugs (12 patients), post-hypoxic-ischaemic encephalopathy (6 patients), infections (2 cases), mechanical compression of peripheral nerve during surgery (2 cases), and a metabolic complication (1 case). The five patients who met the criteria of posterior reversible encephalopathy syndrome had a favourable outcome. Seven patients died, four of them due to hypoxic-ischaemic encephalopathy. CONCLUSIONS: NC are common in paediatric patients receiving heart, liver, lung, and renal transplants, with acute symptomatic seizures and acute encephalopathy being the most common clinical signs. No differences were found in the NC with the different types of transplants. Neurotoxicity of the immunosuppressive drugs and hypoxic-ischaemic encephalopathy were the main causes of NC, having different management and outcomes. The prognosis was favourable in most of the patients, except for those who had moderate or severe post-hypoxic-ischaemic damage.
Subject(s)
Heart Transplantation/adverse effects , Liver Transplantation/adverse effects , Lung Transplantation/adverse effects , Nervous System Diseases/etiology , Child , Female , Humans , Male , Retrospective StudiesABSTRACT
La definición que el DSM-IV-TR hace del Trastorno por Déficit de Atención e Hiperactividad (TDAH) no hace ninguna referencia a la evidencia de muchos trabajos europeos que demuestran una mayor frecuencia de trastornos motores o alteraciones en el desarrollo de la coordinación en niños con trastornos hipercinéticos. En 1989, la Academia Americana de Psiquiatría incluye la categoría diagnóstica de Trastorno del Desarrollo de la Coordinación (TDC) para definir a niños con dificultades en el desarrollo de habilidades motoras. Existe un fenotipo clínico con entidad propia caracterizado por reunir criterios de TDAH y de TDC, en ausencia de retraso mental y parálisis cerebral, descrito por autores escandinavos en la década de los 70, conocido por el acrónimo DAMP (Déficit de Atención, control Motor y de la Percepción), que se presenta hasta en un 50% de los pacientes con ambos diagnósticos. La evolución natural del niño con DAMP es menos favorable que en el TDAH puro, con mayor riesgo de fracaso escolar e incluso de ser víctimas de acoso escolar. Los neuropediatras y pediatras, pero también los psiquiatras infantiles, deben reconocer y evaluar las dificultades motoras y de coordinación de estos pacientes y realizar recomendaciones apropiadas. Nuestro objetivo es destacar la importancia de los trastornos motores en el niño afecto de TDAH y contribuir a la difusión de esta entidad que va a precisar un abordaje diagnóstico y terapéutico diferenciado
The definition for ADHD within the DSM-IV-TR doesn't refer to the evidence of any European papers which show a higher frequency of motor impairment or alterations in the development of coordination in children with hyperkinetic disorders. In 1989, the American Academy of Psychiatry includes the diagnostic category of Developmental Disorder Coordination (DCD) to diagnose children with difficulties in the development of motor skills. There is a clinical phenotype characterized as a separated entity with criteria for ADHD and DCD, in the absence of mental retardation and cerebral palsy, described by scandinavian authors in the 70's and known by the acronym DAMP (Deficit in Attention, Motor control and Perception), which occurs in up to 50% of patients with both diagnoses. The natural history of children with DAMP is less favorable than pure ADHD, with greater risk of school failure and even of bullying. The neurologists, pediatricians and pediatric psychiatrists must recognize and evaluate motor and coordination difficulties of these patients and make appropriate recomendations. Our aim is to note the importance of motor disorders in children with ADHD and contribute to spread differential diagnosis and therapeutic approaches
Subject(s)
Humans , Child , Attention Deficit Disorder with Hyperactivity/diagnosis , Motor Skills Disorders/diagnosis , Perceptual Disorders/diagnosis , Neurodevelopmental Disorders/diagnosis , Diagnosis, Differential , Attention Deficit Disorder with Hyperactivity/classificationABSTRACT
La encefalopatía aguda necrosante (EAN) es una encefalopatía rápidamente progresiva que se presenta en niños por lo demás normales asociada a infecciones víricas comunes, como influenza y parainfluenza. La mayoría de los casos son esporádicos y no recurrentes, y se han descrito en pacientes asiáticos, aunque también se han comunicado casos aislados en países occidentales. Recientemente se han encontrado mutaciones en heterocigosis de un gen que codifica una proteína componente del poro nuclear, denominada Ran Binding Protein 2 (RANBP2), en un número significativo de pacientes con esta forma familiar o recurrente de EAN.A continuación se describe una familia española con la forma familiar y recurrente de EAN, en la que el estudio de secuenciación del gen RANBP2 fue negativo. Las mutaciones del gen RANBP2 no son el único alelo que determina susceptibilidad para el desarrollo de la forma familiar o recurrente de EAN (AU)
Acute necrotizing encephalopathy (ANE) presents in children after common viral infections. Most cases of ANE are non-familial and non-recurrent and have been mainly reported in Asian patients, although ANE affects children worldwide. Recently, missense mutations in the gene encoding the nuclear pore protein Ran Binding Protein 2 (RANBP2) have been found in several families with familial or recurrent cases of ANE. We describe a Spanish family with familial and recurrent ANE without mutations in RANBP2. Mutations in RANBP2 are not the sole susceptibility alleles for familial or recurrent ANE (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Brain Diseases/congenital , Virus Diseases/complications , Recurrence , Chromosome Aberrations , Genetic Predisposition to Disease , MutationABSTRACT
Acute necrotizing encephalopathy (ANE) presents in children after common viral infections. Most cases of ANE are non-familial and non-recurrent and have been mainly reported in Asian patients, although ANE affects children worldwide. Recently, missense mutations in the gene encoding the nuclear pore protein Ran Binding Protein 2 (RANBP2) have been found in several families with familial or recurrent cases of ANE. We describe a Spanish family with familial and recurrent ANE without mutations in RANBP2. Mutations in RANBP2 are not the sole susceptibility alleles for familial or recurrent ANE.
Subject(s)
Leukoencephalitis, Acute Hemorrhagic/genetics , Child, Preschool , Fatal Outcome , Female , Humans , Infant , Infections , Leukoencephalitis, Acute Hemorrhagic/microbiology , Male , Pedigree , RecurrenceSubject(s)
alpha-Mannosidosis/diagnosis , Child, Preschool , Diagnosis, Differential , Health Status , Humans , Male , Phenotype , Severity of Illness IndexABSTRACT
No disponible
Subject(s)
Humans , Male , Child , alpha-Mannosidosis/complications , alpha-Mannosidosis/diagnosis , Hernia, Umbilical/diagnosis , Hearing Loss, Sensorineural/complications , Chromatography/methods , Intellectual Disability/complications , Intellectual Disability/diagnosis , Prenatal Diagnosis/methods , Prenatal Diagnosis/trends , Oligosaccharides/urine , Dysostoses/complications , Splenomegaly/complications , Craniosynostoses/complications , Hernia/complications , Hypertelorism/complications , Oligosaccharides/analysis , alpha-Mannosidase/deficiencyABSTRACT
No disponible
Subject(s)
Humans , Female , Adolescent , Rett Syndrome/diagnosis , Autistic Disorder/complications , Intellectual Disability/complications , Primary Health Care/methodsSubject(s)
Brain Neoplasms , Neoplasms, Neuroepithelial , Adolescent , Brain Neoplasms/diagnosis , Brain Neoplasms/pathology , Brain Neoplasms/physiopathology , Child , Female , Humans , Infant , Magnetic Resonance Imaging , Neoplasms, Neuroepithelial/diagnosis , Neoplasms, Neuroepithelial/pathology , Neoplasms, Neuroepithelial/physiopathology , Retrospective StudiesABSTRACT
No disponible
No disponible
Subject(s)
Humans , Female , Infant , Child , Adolescent , Teratoma/diagnosis , Neuroectodermal Tumors, Primitive, Peripheral/diagnosis , Neuroglia/pathology , Epilepsies, Partial , NeuroimagingABSTRACT
AIMS: The objective of this work was to produce a scientific evidence-based guide to clinical practice dealing with the basic questions concerning the treatment of epilepsy. DEVELOPMENT: A committee of 11 experts belonging to the Andalusia Epilepsy Society, made up of six neurologists, three neuropaediatricians, one neurosurgeon and a pharmacologist, all of whom were deeply involved and experienced in epilepsy, conducted a thorough review of the literature in search of all the evidence available on the proposed subject matter. The following databases were used: MEDLINE, Cochrane Library and the databases of several clinical practice guidelines (National Guideline Clearinghouse, National Institute of Clinical Excellence and the American Academy of Neurology's Clinical Guidelines). The Guide was set out in seven sections and was published in four parts. From a total number of 187 relevant documents, the committee found 63 examples of scientific evidence and 91 therapeutic recommendations. These were tabulated and classified according to the European Federation of Neurological Societies' criteria for producing Clinical Practice Guidelines. CONCLUSIONS: The results of this survey provide scientific evidence-based clinical guidelines that are useful, simple and applicable at different levels of health care.
Subject(s)
Anticonvulsants/therapeutic use , Epilepsy/drug therapy , Guidelines as Topic , Adult , Child , Child, Preschool , Databases, Factual , Evidence-Based Medicine , Humans , Infant , SpainABSTRACT
AIMS: The objective of this work was to produce a scientific evidence-based guide to clinical practice dealing with the basic questions concerning the treatment of epilepsy. DEVELOPMENT: A committee of 11 experts belonging to the Andalusia Epilepsy Society, made up of six neurologists, three neuropaediatricians, one neurosurgeon and a pharmacologist, all of whom were deeply involved and experienced in epilepsy, conducted a thorough review of the literature in search of all the evidence available on the proposed subject matter. The following databases were used: MEDLINE, Cochrane Library and the databases of several clinical practice guidelines (National Guideline Clearinghouse, National Institute of Clinical Excellence and the American Academy of Neurology's Clinical Guidelines). The Guide was set out in seven sections and was published in four parts. From a total number of 187 relevant documents, the committee found 63 examples of scientific evidence and 91 therapeutic recommendations. These were tabulated and classified according to the European Federation of Neurological Societies' criteria for producing Clinical Practice Guidelines. CONCLUSIONS: The results of this survey provide scientific evidence-based clinical guidelines that are useful, simple and applicable at different levels of health care.
Subject(s)
Anticonvulsants/therapeutic use , Drug Resistance , Epilepsy/therapy , Neurology/methods , Brain/physiopathology , Brain/surgery , Combined Modality Therapy , Electric Stimulation Therapy , Epilepsy/physiopathology , Epilepsy, Temporal Lobe/surgery , Functional Laterality/physiology , Humans , Neurosurgical Procedures/methods , Spain , Vagus Nerve/physiologyABSTRACT
AIMS: The objective of this work was to produce a scientific evidence-based guide to clinical practice dealing with the basic questions concerning the treatment of epilepsy. DEVELOPMENT: A committee of 11 experts belonging to the Andalusia Epilepsy Society, made up of six neurologists, three neuropaediatricians, one neurosurgeon and a pharmacologist, all of whom were deeply involved and experienced in epilepsy, conducted a thorough review of the literature in search of all the evidence available on the proposed subject matter. The following databases were used: MEDLINE, Cochrane Library and the databases of several clinical practice guidelines (National Guideline Clearinghouse, National Institute of Clinical Excellence and the American Academy of Neurology's Clinical Guidelines). The Guide was set out in seven sections and was published in four parts. From a total number of 187 relevant documents, the committee found 63 examples of scientific evidence and 91 therapeutic recommendations. These were tabulated and classified according to the European Federation of Neurological Societies' criteria for producing Clinical Practice Guidelines. CONCLUSIONS: The results of this survey provide scientific evidence-based clinical guidelines that are useful, simple and applicable at different levels of health care.
Subject(s)
Anticonvulsants/therapeutic use , Epilepsy/drug therapy , Abnormalities, Drug-Induced/etiology , Aged , Anticonvulsants/administration & dosage , Anticonvulsants/adverse effects , Anticonvulsants/pharmacokinetics , Brain Diseases/complications , Contraceptives, Oral, Hormonal/pharmacokinetics , Drug Interactions , Drug Therapy, Combination , Epilepsy/complications , Evidence-Based Medicine , Female , Graft Rejection/drug therapy , HIV Infections/complications , Hemorrhage/chemically induced , Humans , Immunosuppressive Agents/pharmacokinetics , Kidney Diseases/complications , Kidney Diseases/metabolism , Liver Diseases/complications , Male , Porphyrias/complications , Pregnancy , Pregnancy Complications/drug therapy , Prenatal Exposure Delayed Effects , Respiratory Tract Diseases/complications , Seizures, Febrile/drug therapy , Status Epilepticus/drug therapyABSTRACT
Aims. The objective of this work was to produce a scientific evidence-based guide to clinical practice dealing with the basic questions concerning the treatment of epilepsy. Development. A committee of 11 experts belonging to the Andalusia Epilepsy Society, made up of six neurologists, three neuropaediatricians, one neurosurgeon and a pharmacologist, all of whom were deeply involved and experienced in epilepsy, conducted a thorough review of the literature in search of all the evidence available on the proposed subject matter. The following databases were used: MEDLINE, Cochrane Library and the databases of several clinical practice guidelines (National Guideline Clearinghouse, National Institute of Clinical Excellence and the American Academy of Neurologys Clinical Guidelines). The Guide was set out in seven sections and was published in four parts. From a total number of 187 relevant documents, the committee found 63 examples of scientific evidence and 91 therapeutic recommendations. These were tabulated and classified according to the European Federation of Neurological Societies criteria for producing Clinical Practice Guidelines. Conclusions. The results of this survey provide scientific evidence-based clinical guidelines that are useful, simple and applicable at different levels of health care (AU)
Objetivo. Elaborar una guía de práctica clínica basada en la evidencia científica que aborde las cuestiones básicas acerca del tratamiento de la epilepsia. Desarrollo. Un comité de 11 expertos pertenecientes a la Sociedad Andaluza de Epilepsia, en el que se incluían seis neurólogos, tres neuropediatras, un neurocirujano y una farmacóloga, todos con especial dedicación y competencia en epilepsia, realizó una revisión bibliográfica exhaustiva en busca de las evidencias disponibles relacionadas con el tema propuesto. Se utilizaron las siguientes bases de datos: MEDLINE, Cochrane Library y bases de datos de guías de práctica clínica (National Guideline Clearinghouse, National Institute of Clinical Excellence y Guías Clínicas de la Academia Americana de Neurología). La guía se estructuró en siete secciones y se dividió para su publicación en cuatro partes. Se identificaron 187 documentos relevantes, de los que se extrajeron un total de 63 evidencias científicas y 91 recomendaciones terapéuticas, que se tabularon y clasificaron según los criterios de elaboración de Guías de Práctica Clínica de la Federación Europea de Sociedades Neurológicas. Conclusión. Los resultados de esta revisión proveen unas guías de práctica clínica basadas en la evidencia científica útiles, sencillas y aplicables en los diferentes niveles asistenciales (AU)
