Achados tomográficos em 1000 pacientes consecutivos com antecedentes de crises epilépticas

Abstract

RESUMO -Analizamos retrospectivamente as tomografias computadorizadas (TC) de crânio de 1000 pacientes consecutivos, com história clínica de crises epilépticas classificadas do ponto de vista clínico em generalizadas (CG) e parciais (CP). Nossos resultados mostraram a presença de CG em 70,7% dos pacientes, sendo 57,1% do sexo masculino e 42,9% do sexo feminino e, CP em 29,3%, sendo 60,0% do sexo maculino e 40,0% do sexo femninino. As faixas etárias de maior incidência foram entre 0 a 10 (31,0%) e 11 a 20 (21,8%) anos nos pacientes com CG e 0 a 10 (24,5%), 21 a 30 (16,7%) e 31 a 40 anos (18,4%) nos pacientes com CP. Os resultados tomográficos no grupo com CG foram: normais (48,8%) e alterados em 51,2%, sendo esses achados definidos como calcificações/cisticercose (14,0%), neurocisticercose/cistos (9,6%) hidrocefalia (4,4%), infarto (4,2%), indefinido (4,0%), tumor (2,5%) entre outros (12,5,%). Nos pacientes com CP os exames tomográficos foram normais em 37,4%, alterados em 62,7%, tendo os diagnósticos de neurocisticercose/cistos (12,2%), calcificações/cisticercose (11,2%), tumor (10,5%), indefinido (8,1%), infarto (5,4%), hidrocefalia (3,7%) e outros (11,6%). Salientamos a importância da TC em pacientes com epilepsia, particularmente para o diagnóstico de neurocisticercose.PALAVRAS-CHAVE: epilepsia, tomografia computadorizada, neurocisticercose.CT findings in 1000 consecutive patients with seizures CT findings in 1000 consecutive patients with seizures CT findings in 1000 consecutive patients with seizures CT findings in 1000 consecutive patients with seizures CT findings in 1000 consecutive patients with seizures ABSTRACT -We analized the cranial computorized tomography scans (CT) of 1000 consecutive patients with the history of seizures. The seizures were classified in generalized tonic-clonic seizures (GS) and partial seizures (PS) on the basis of the clinical semiology, as it was described by the patients and family members. Seizure types were correlated with age group, sex and CT findings. GS were observed in 70.7% of the patients and PS in 29.3 %. An increased incidence of GS was noted among the age groups 0 to 10 yrs (31%) and 11 to 20 yrs (21.8%). For PS the 0 to 10 yrs (24.5 %), 21 to 30 yrs (16.7%) and 31 tp 40 yrs (18.5%) age groups were the most prevalent groups. The CT scan findings for the GS group were the following: normal studies 48.8 % of the patients, calcifications/cysticercosis (14.0%), neurocysticercosis/cysts (9.6 %), hydrocephalus (4.3%), ischemia (4.2 %), non-definite lesions (4.1 %), tumor (2.5%), and others (12.5%). In the PS group we found 37.4% of normal studies, calcifications/cysticercosis (11.2%), neurocysticercosis/cysts (12.2%), tumor (10.5%), ischemia (5.4%), hydrocephalus (3.7%), non-definite lesions (8.1%) and others (11.6%). We emphasize the importance of CT scan imaging in patients presenting with seizures, particularly in the diagnosis of cysticercosis.KEY WORDS: epilepsy, computed tomography, cysticercosis.A determinação da etiologia das crises epilépti-cas mudou significa...

Perfil clínico-epidemiológico de pacientes com neurocisticercose atendidos no Hospital Universitário Regional de Maringá, Paraná, Brasil

“…A taxa de freqüência de NCC encontrada no HURM, de 0,78%, foi inferior à verificada em hospitais gerais brasileiros (1,94 a 2,03%) 12 e à constatada em outros estudos [16][17][18] , mas superior à observada no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (0,2%) 19 . Um ponto a ser ressaltado foi a disparidade entre o número de atendimentos realizados pelo HURM e os casos notificados à Secretaria de Saúde do município de Maringá que revela a existência de desencontros no sistema de informação entre as entidades, o que merece ser mais bem analisado.…”

Anatomopathological aspects of neurocysticercosis in autopsied patients

“…Cysticerci may be found in an active form causing arachnoiditis, hydrocephaly by meningeal inflammation, parenchymatous cysts and cerebral infarct; or in an inactive form that can be constituted by parenchymatous calcifications. The most common signs and symptoms of NCC are epilepsy, cephalalgia, papilledema, vomit and pyramidal signs [14][15][16][17][18][19] . Accordingly to Takayanagui and Leite 20 , in a review article, the frequency of these manifestations are: epileptic crisis (62%), intracranial hypertension syndrome (38%), cysticercotic meningitis (35%), psychic disturbance (11%), apoplectic or endarteritic form (2.8%) and spinal cord syndrome (0.5%).…”