RESUMO
OBJECTIVE: To identify prevalence and factors associated with occurrence of focal clinical and electroencephalogram (EEG) abnormalities in patients with juvenile myoclonic epilepsy (JME). MATERIALS AND METHODS: Clinical asymmetries in the seizures and focal EEG abnormalities were analyzed in 266 patients with JME. RESULTS: All the patients had myoclonic jerks (MJ) and generalized tonic-clonic seizures (GTCS); 56 (21%) had absence seizures. Asymmetry in clinical seizures was reported in 45 (16.9%) and focal EEG abnormalities were noted in 92 (45.5%) patients. Amplitude asymmetry or focal onset of generalized discharges was noted in 41 (44.6%) and independent focal EEG abnormalities in 30 (32.6%) patients. A statistically significant association was seen with the presence of GTCS and MJ (P = 0.007), a family history of epilepsy (P = 0.001) and drug resistance (P = 0.04) and the occurrence of focal EEG abnormalities. CONCLUSION: Patients with JME showed focal clinical and EEG features. These features should not be misinterpreted as indicative of partial epilepsy.
Assuntos
Países em Desenvolvimento , Eletroencefalografia , Epilepsias Parciais/diagnóstico , Epilepsias Parciais/epidemiologia , Epilepsia Mioclônica Juvenil/diagnóstico , Epilepsia Mioclônica Juvenil/epidemiologia , Processamento de Sinais Assistido por Computador , Adolescente , Adulto , Idade de Início , Córtex Cerebral/fisiopatologia , Criança , Pré-Escolar , Estudos Transversais , Ritmo Delta , Dominância Cerebral/fisiologia , Epilepsias Parciais/fisiopatologia , Epilepsia Tipo Ausência/diagnóstico , Epilepsia Tipo Ausência/epidemiologia , Epilepsia Tipo Ausência/fisiopatologia , Epilepsia Generalizada/diagnóstico , Epilepsia Generalizada/epidemiologia , Epilepsia Generalizada/fisiopatologia , Epilepsia Tônico-Clônica/diagnóstico , Epilepsia Tônico-Clônica/epidemiologia , Epilepsia Tônico-Clônica/fisiopatologia , Potenciais Evocados/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Epilepsia Mioclônica Juvenil/fisiopatologia , Estudos Prospectivos , Adulto JovemRESUMO
AIMS: To describe the pathology of central nervous system (CNS) fungal infections with particular reference to India. METHODS AND RESULTS: This was a retrospective study from 1988 to 2004 constituting 130 cases. The diagnosis was based on morphology of biopsy/autopsy material. These included aspergillosis (n=73), zygomycosis (n=40), cryptococcosis (n=2), rhodotorulosis (n=1), candidiasis (n=5), maduramycosis (n=1), pheohyphomycosis (n=3) and mixed infections (n=5). Predisposing risk factors were present in 49 (38%) patients only. The majority of the patients were immunocompetent. The commonest risk factor was diabetes mellitus, the commonest route of infection was from a contiguous site and the commonest pathology was granuloma. Culture positivity was seen in only 31%. CONCLUSION: Environmental factors in tropical countries such as India play a significant role in the pathogenesis of CNS fungal infections.
