Eficácia e segurança durante monitorização por vídeo-eletroencefalograma em pacientes com epilepsia generalizada genética

• Ano de defesa: 2017
• Autor(a) principal: De Marchi, Luciana Rodrigues [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Epilepsia; Epilepsias generalizadas genéticas; Protocolo neuropsicológico; Eficácia; Segurança; Traços reflexos
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5454350; http://repositorio.unifesp.br/handle/11600/49971

Video-EEG has been used to characterize genetic generalized epilepsies (GGE). For best performance, sleep recording, photic stimulation, hyperventilation and neuropsychological protocols are added to the monitoring. However, risks and benefits of these video-EEG protocols are not well established. The aim of this article is to analyze the efficacy and safety of a video-EEG neuropsychological protocol (VNPP) tailored for GGE and compare its value with that of routine EEG (R-EEG). We reviewed the VNPP and R-EEG of patients with GGE. We considered confirmation of the clinical hypothesis of a GGE syndrome and characterization of reflex traits as benefits; and falls, injuries, psychiatric and behavioral changes, generalized tonic-clonic (GTC) seizures and status epilepticus (SE) as the main risks of the VNPP. The VNPP of 113 patients were analyzed. The most common epileptic syndrome was juvenile myoclonic epilepsy (85.8%). The protocol confirmed a GGE syndrome in 97 patients and 62 presented seizures. Sleep recording had a provocative effect in 51.2% of patients. The task that showed highest efficacy was praxis (39.3%), followed by hyperventilation (31.3%). Among the risks, 1.8% had GTC seizures and another 1.8%, SE. Eighteen percent of patients had persistently normal R-EEG, 72.2% of them had discharges during VNPP. GTC seizures, myoclonic SE, repeated seizures were the main risks of VNPP present in 6 (5.31%) patients while there were no complications during R-EEG. We conclude that the VNPP in GGE is a useful tool in diagnosis, characterization of reflex traits and is a safe procedure. Its use might preclude multiple R-EEG exams.