Regresar

The distribution and etiology of epilepsy in the tropics of America

Abstract:

Over the last decade there has been a increasing number of epidemiological studies in Latin America. The majority of these studies report a point prevalence of active recurrent afebrile seizures between 17 and 22 (per 1000), and an incidence from 113 to 190 (per 100000). The frequency of epilepsy appears greater among Latin American countries than developed countries. Whether this difference is due to methodological issues or to factors such as potential increased risk associated with poor perinatal care, head injury and infectious and parasitic diseases, remains unanswered. Studies of etiology of epilepsy are few and are targeted on all the seizures instead of epilepsy only. Almost all the studies are prevalent case-series, which are not useful for identifying cause of seizures; nevertheless, the available information show that the ratio of idiopathic (30-40%) to symptomatic epilepsy (60-70%) remains constant in comparison to the studies from developed countries. Among the symptomatic group, infection and parasitic diseases, particularly neurocysticercosis, perinatal brain damage, and head trauma are the more frequent disorders reported as cause of epilepsy in some developing countries form Latin American. Several parasitic diseases peculiar to the tropics (i.e. malaria, schistosomiasis, trypanosomiasis and paragonimiasis) are also associated with the development of seizures; so far, no epidemiological study has found these tropical diseases to be a risk factor for epilepsy. Further prospective studies are required to look for risk factors for epilepsy in Latin American countries. We suggest to perform collaborative studies using similar methodology and definitions in order to identify potential preventable causes of epilepsy.