Introduction. Alcohol withdrawal syndrome (AWS) can occur in about half of patients with alcohol use disorder who abruptly reduce or cease consumption of this substance. Epileptic seizures are one of the possible manifestations. Objective. Evaluate epidemiological data, clinical characteristics, length of hospital stay and recurrence of emergency medical care between patients with alcohol withdrawal-related epileptic seizures. Method. This is a retrospective observational study, with data collection from medical records of patients treated for epileptic seizures caused by AWS in a public hospital in Minas Gerais within a year. Inferential statistical association between nominal variables was assessed by cross-tabulation with the chi-square test. Results. 45 patients were included in the study. The most prevalent age group was 35 to 45 years (37.7%). In 46.6%, it was described a previous diagnosis of epilepsy. There was an association between the previous diagnosis of epilepsy and the presence of epileptic seizures (p<0.001). The type of seizure was generalized tonic-clonic since the onset in 92% of cases. 78% had seizures up to 48 hours after the last alcohol consumption. The rate of recurrence at the emergency department during the year was 31%. Conclusion. AWS-related epileptic seizures predominantly affect young men and are associated with a high recurrence rate of need of emergency hospital care, being a complex public health problem. These data point to the need to strengthen strategies for primary prevention.
BackgroundHeadache is a common symptom that affects a significant portion of the general population. It constitutes a challenge for diagnosis in urgency and emergency care services, due to headache’s clinical variability and diverse possible etiologies, besides the limited time and resources of these facilities. Because of this insufficiency and the potential severity associated with the condition, headaches generate considerable expenditures to health systems, related to both diagnostic discrimination and treatment.ObjectiveEvaluating the diagnostic resources used on headache patients care, as well as its Public Health Relevanceand relation to cost in an Emergency and Urgency Care unit.MethodsCross-section study analyzing 450 medical records of patients with headache complaints in the time frame from January 1, 2019, and December 31, 2019. Patients were categorized according to the type of headache (primary and secondary), specialized evaluation, complementary exams used in the diagnosis, hospital observation time, and the final expenditure in each patient’s care.ResultsThe total estimated expenditures related to headache care equaled US$90,855.60 (average US$201.90 per patient). 38.9% of cases corresponded to primary headaches and 31.1% to secondary headaches. 30% of cases could not be classified. The resources utilized for secondary headaches diagnosis differed significantly from those used in primary headache diagnosis. However, the final expenditures were similar to both groups.ConclusionThe socio-economic impact caused by headaches is unquestionable. It is a highly frequent symptom and both its etiological distinction and adequate treatment require solid evaluation. Due to the resources spent in its evaluation and monitoring, headaches can be considered a public health problem. Therefore, this study suggests that resources should be allocated in the health education and professional training for the proper conduction of these patients, so that they may benefit from an optimized treatment of theircondition without overwhelming the health system.
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