Epidemiological survey of epilepsy in the special school population in the city of Buenos Aires. A comparison with mainstream schools.

BACKGROUND: Previous studies in special schools have shown a high prevalence of epilepsy, which is strongly associated with cerebral palsy and severe mental retardation. The conditions regulating school placement have also been described in those studies. In the City of Buenos Aires, information is known only for mainstream schools. OBJECTIVE: To determine the prevalence and characteristics of epilepsy in special schools and to compare results with common primary education settings. DESIGN AND METHODS: A cross-sectional study was carried out in special schools in the City of Buenos Aires, by adopting the same definitions, diagnostic criteria and questionnaire as those used in a previous study in the common primary school population. Responses from 1,682 children, aged 6-16 years, residing in the City of Buenos Aires, with mental retardation, visual or hearing impairment, psychiatric disorders and motor disabilities were analyzed. RESULTS: A total of 121 children with epilepsy were detected. Lifetime prevalence was 71.9 per thousand and active prevalence was 64.8 per thousand (22-25 times greater than rates in mainstream schools). Prevalence was highest in girls and generalized seizures prevailed over other seizure types. Ninety-two percent of cases received antiepileptic drugs, 57.9% as a single drug treatment and 85.1% in adequate doses. Only 56% of the children with a diagnosis of epilepsy proved to be true-positive cases, and almost 40% received antiepileptic drugs for nonepileptic disorders. Malformations/degenerative disease were the most common etiology. CONCLUSIONS: Special schools contain clusters of children with epilepsy as a comorbid condition. False high frequency is due to misdiagnoses and unnecessary treatments. These schools are an important target for educational interventions.

Epidemiological survey of epilepsy in the primary school population in Buenos Aires.

BACKGROUND: Most studies carried out in Latin America have shown greater rates of epilepsy and generalized seizures than those observed in developed countries, in spite of lower numbers of patients receiving treatment. To date, studies in Argentina have been insufficient to establish true prevalence. OBJECTIVE: To determine the prevalence of epilepsy in primary school children in Buenos Aires, together with rates of different seizure types, treatments prescribed, diagnoses made and number of inadequate therapies administered, as well as the relationship between epilepsy and learning difficulties. DESIGN AND METHOD: A cross-sectional study was carried out on 10% of the entire primary school population of Buenos Aires through randomized, systematic, representative and conglomerate sampling of public and private school students. A total of 26,270 responses were received (83.1% of the population) to a specially designed questionnaire, with 96.4% sensitivity and 41.5% specificity, respectively. Interviews were conducted in all probable epilepsy cases as well as in a random sample of probable negative ones. RESULTS: Eighty-four children with epilepsy were detected (lifetime prevalence 3.2 per thousand; active prevalence 2.6 per thousand), in whom generalized seizures predominated (57.1%). Ninety-three percent of cases diagnosed were currently under, or had previously received antiepileptic drug (AED) therapy. Almost 1% of the primary school population studied had a prior diagnosis and/or received AED for dysrhythmia or epilepsy. The percentage of grade repeaters in the general population and in children with epilepsy was 8.4 and 26.2%, respectively. CONCLUSIONS: (1) The prevalence of epilepsy in primary school children in Buenos Aires is similar to that reported for developed countries; (2) a slight prevalence for generalized seizures was observed; (3) 93% of cases received AEDs; (4) misdiagnoses and unnecessary treatments exceeded correct diagnoses and adequate therapy, and (5) disease presence and/or treatment were associated with poorer school performance.

Toxoplasmosis / Toxoplasmosis

La toxoplasmosis es una antropozoonosis muy difundida en todas las latitudes, que no respeta raza ni clase social y que aumenta estadísticamente con la edad. Por lo mismo, cada vez se le otorga mayor importancia. Los equívocos y las falsas interpretaciones en torno de esta parasitosis mantenidos en épocas precedentes fueron desvaneciéndose a medida que se desarrolló el juicio crítico frente a afecciones que coinciden o se confunden hartas veces con la toxoplasmosis. Ello coincidió con un mejor conocimiento de las lesiones que es capaz de producir el Toxoplasma gondii y con la existencia de métodos diagnósticos más perfeccionados y exactos. En este libro se aclara el verdadero valor y alcance de la etiología toxoplásmica, sobre todo en el campo de la pediatría prenatal y en el de la oftalmología, y se reúnen los conocimientos dispersos en múltiples publicaciones. (AU)