Publications (2)1.07 Total impact
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ABSTRACT: Juvenile absence epilepsy (JAE) is a generalized form of epilepsy, characterized by absence seizures (AS) initiated in adolescence, with a typical EEG showing generalized spike-wave discharges. Apart from absences, other seizure types may be observed such as myoclonia and generalized tonic-clonic seizures (GTCS). Its long-term prognosis is uncertain. We retrospectively selected all patients who met the 1989 ILAE diagnostic criteria for JAE. We analysed clinical variables, pharmacological treatment, and seizure remission with medical treatment and seizure relapse after stopping medical treatment. We identified 21 patients, 17 women and 4 men, 86% of whom had suffered GTCS and 14% myoclonias. Mean age at AS onset was 17 years old (range 10-44), 4 patients debuted with AS in adulthood. Mean follow up duration was 25 years (range 10-43). Ninety per cent of the patients were treated with valproate and 62% needed polytherapy. Currently 43% have achieved seizure freedom under medical treatment. All attempts to stop treatment failed, in some cases after long periods of seizure remission. Less than fifty per cent of patients with JAE achieve remission, antiepileptic treatment is mandatory during all life, despite having long periods of remission.Neurologia 05/2011; 26(4):193-9.
Article: [Status epilepticus].[show abstract] [hide abstract]
ABSTRACT: Status epilepticus is a neurological emergency that requires prompt care. The diagnosis and treatment must be continuous from the first minutes to its resolution. The most frequent cause in epileptic patients is drug change or non-compliance and in the non-epileptic patients are cerebrovascular diseases, head trauma, drug toxicity and metabolic disturbances. Status epilepticus can be convulsive or non-convulsive and continuous electroencephalographic monitoring is useful for diagnosis and to evaluate response to treatment. Benzodiazepines and phenytoin or fosphenytoin are first-line and second-line therapy. There is no agreement on third and fourth line therapy: phenobarbital, valproate, levetiracetam, propofol, midazolam, barbiturates and others. The prognosis of status epilepticus is related to etiology, age, type and duration of the status. Thus, drug treatment for status epilepticus should be started without delay.Medicina Intensiva 06/2008; 32(4):174-82. · 1.07 Impact Factor