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Las convulsiones de inicio tardío como predictor de un accidente cerebrovascular posterior
Paul Cleary1, Simon Shorvon, Raymond Tallis
1Brownlee Centre, Gartnavel General Hospital, Glasgow, UK.
Lancet (London, England)
|April 15, 2004
Resumen
Las convulsiones de edad avanzada aumentan significativamente el riesgo de accidente cerebrovascular. Este estudio encontró que las personas que experimentan convulsiones de nueva aparición después de los 60 años se enfrentan a un riesgo casi tres veces mayor de accidente cerebrovascular posterior.
Área de la Ciencia:
- Neurología Neurología.
- Epidemiología La epidemiología.
- Geriatría La geriatría es la especialidad de la geriatría.
Sus antecedentes:
- La enfermedad cerebrovascular es una causa conocida de epilepsia tardía.
- La relación entre las convulsiones de nueva aparición y el riesgo subsiguiente de accidente cerebrovascular en adultos mayores no se entiende completamente.
Objetivo del estudio:
- Investigar la hipótesis de que las convulsiones de nueva aparición en personas mayores de 60 años sin antecedentes de accidente cerebrovascular están asociadas con un mayor riesgo de accidente cerebrovascular futuro.
Principales métodos:
- Un estudio de la Base de Datos de Investigación de Práctica General del Reino Unido incluyó a 4709 individuos con convulsiones de nueva aparición (edad ≥60) y 4709 controles emparejados.
- Los criterios de exclusión incluyeron enfermedades cerebrovasculares previas, lesiones cerebrales, tumores, abuso de sustancias o demencia.
- Se analizaron los registros de los pacientes para los diagnósticos posteriores de accidente cerebrovascular.
Principales resultados:
- Las pruebas log-rank revelaron una diferencia muy significativa en la supervivencia libre de accidente cerebrovascular entre los grupos (p<0.0001).
- El modelo de Cox estimó un riesgo relativo de 2,89 (95% IC 2,45-3,41) para el accidente cerebrovascular en el grupo de convulsiones en comparación con los controles.
Conclusiones:
- La aparición de convulsiones en los últimos años de la vida está relacionada con un aumento sustancial en el riesgo de accidente cerebrovascular.
- Se necesitan más investigaciones para evaluar las intervenciones destinadas a prevenir el accidente cerebrovascular en pacientes con convulsiones en edad avanzada.
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