Estado epiléptico convulsivo: Características clínico-epidemiológicas y factores de riesgo en Perú

Introduction: Convulsive status epilepticus constitutes a medical emergency that requires a fast and aggressive management with the objective to prevent neuronal damage and systemic complications. The objective is to determine clinico-epidemiologic characteristics and risk factors associated with convulsive status epilepticus in adults attended in a National Hospital from Lima-Peru in a period of four years. Methods: Case-control study. Cases were constituted by patients admitted for convulsive status epilepticus in the Adult Emergency Service of National Hospital Dos de Mayo between January 2003 and December 2007. Controls were patients with diagnoses of epilepsy that received treatment in outpatient service of neurology, couplet by age and sex with the group of cases. Medical histories were reviewed and patients were interviewed obtaining clinical, epidemiologic and possible risk factors to convulsive status epilepticus that were registered in an instrument of data recorded. Results: 41 cases of convulsive status epilepticus were presented. 68.3% were male, 28.6% had age between 20 and 29 years old and 15.5% resided in endemic areas of neurocysticercosis. The more frequent aetiologies were remote symptomatic secondary crisis to cranio encephalic trauma and neurocysticercosis and idiopathic; 26.8% showed some intercurrent infection; while, mortality was of 7.3%. Factors associated with a convulsive status epilepticus were the abrupt interruption or suspension of drugs used for the control of convulsions (p=0.038), chronic intake of alcohol (p=0.030) and irregular antiepileptic treatment (p=0.006). Conclusions: Aetiologies more frequent in the hospital studied from Lima-Peru are remote symptomatic secondary crisis to cranio encephalic trauma, neurocysticercosis and idiopathic. The irregular antiepilepticus treatment constitutes a risk factor to convulsive status epilepticus.