Aim . The aim of the study was to evaluate the clinical applicability of the 2017 ILAE classification of seizures and epilepsies through the analysis of a sample of 100 outpatients with a diagnosis of epilepsy. Methods . All clinical charts were reviewed applying both the 1981/1989 and 2017 classifications of seizures and epilepsies, respectively. For most focal seizures, descriptors were required to include all the relevant clinical information. The reclassification of complex partial seizures into focal seizures with impaired awareness with a motor / non‐motor onset allowed the inclusion of features of topographic value, although the chronological sequence of awareness impairment was lacking. Results . The use of the term “focal to bilateral tonic‐clonic” reduced the number of seizures classified as generalized tonic‐clonic seizures (GTCS) by 19%. A subset of GTCS (35%) and absence seizures (12.5%) were reclassified as seizures of unknown onset. Most focal symptomatic epilepsies (92%) were reclassified as focal structural epilepsies, while 27% of idiopathic generalized and 7% of focal cryptogenic epilepsies merged into the category of “epilepsies of unknown type”. Conclusion . Major strengths of the new classification are simplicity and the role of the category “unknown onset” to avoid forced categorization. A section assigned to uncertainty reinforces the need for further ancillary studies and periodic diagnostic re‐evaluation.

Stroke accounts for 5.5% of the national Global Burden of Disease (GBD) and ~2,000 deaths per year in Uruguay. To respond to this medical emergency, the Ministry of Public Health (MPH) of Uruguay devised the National Stroke Plan (NSP). Scientific associations, universities, scholars, and patient organizations, both at the national and international levels, took part in the process, which ended with the generation of the national stroke management guidelines, including measures based on the best evidence available. This was accompanied by presidential regulatory decrees and several ordinances that set the foundations of the legal framework for their implementation as of 2020. Forty-two Stroke Ready Centers (SRC) and seven Comprehensive Stroke Centers (CSC) were strategically established and interlinked to ensure compliance with international accessibility recommendations, offering, in turn, the required training for their healthcare teams. A pre-hospital care protocol was also created for all countrywide mobile units. For NSP assessment, stroke was included as a “Care Goal (objective)” for the whole health system, providing the involved healthcare organizations with a financial incentive for compliance with the basic objectives related to the treatment of hyper acute stroke. The NSP came into force during the COVID-19 pandemic and, considering the special circumstances imposed, it made it possible to maintain hyper acute medical care and increase population access to recanalization treatment, particularly mechanical thrombectomy. The purpose of this article is to share our experience in the development of the NSP by describing some preliminary outcomes.

Guillain-Barre syndrome (GBS) is an acute autoimmune peripheral inflammatory neuropathy and the most frequent cause of non-poliovirus acute flaccid paralysis worldwide. Background annual GBS incidence rates (IRs) in Latin America (LA) varies from 0.40 to 2.12/100000 persons per year. We performed a prospective populationbased epidemiological study to determine the incidence and clinical profile of GBS in the most densely populated regions in Uruguay. The incidence of GBS in the population living in Montevideo and Canelones was studied in the period between June 01, 2018 and May 31, 2020. Patients older than 16 years of age diagnosed with GBS were prospectively enrolled. The mean global annual IR in the Uruguayan population was 1.7/100000 persons (95% CI 1.25-2.25). The highest rate was observed in the 65 to 74 age group among men (5.25/100000 per year) and in the 55 to 64 age group among women (2/100.000 per year). The mean age was 53.9 ± 19.5, years, without difference by sex (53.5 women, 54.5 men). The in-hospital mortality rate was 5.8%. A total of 51 patients were diagnosed with GBS: 42 (82%) had typical GBS, 5 (10%) Miller-Fisher syndrome (MFS), 3 (7%) a bilateral facial nerve palsy, 1 patient had a GBS-MFS overlap (2.3%). This is the first population-based GBS incidence study in LA using a prospective design. Our IR can be a useful tool in establishing the background rate to examine future disease trends caused by the introduction of new viruses or vaccines in Uruguay.

No abstract