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Una revisión de las convulsiones en adultos y adolescentes
Jay R Gavvala1, Stephan U Schuele2
1Department of Neurology, Baylor College of Medicine, Houston, Texas.
JAMA
|December 28, 2016
Resumen
Muchas personas sufren convulsiones, pero pocas desarrollan epilepsia. El diagnóstico preciso es clave para el tratamiento adecuado, distinguiendo la epilepsia de los ataques únicos o los eventos no epilépticos para evitar la intervención médica innecesaria.
Área de la Ciencia:
- Neurología
- Epileptología
Sus antecedentes:
- Aproximadamente el 8-10% de la población experimenta una convulsión en su vida.
- Sólo el 2-3% de estos individuos desarrollan epilepsia.
- El diagnóstico preciso es crucial para el tratamiento adecuado y para evitar intervenciones innecesarias en pacientes de bajo riesgo.
Objetivo del estudio:
- Para diferenciar entre las convulsiones sintomáticas agudas, las convulsiones no provocadas y la epilepsia de nueva aparición.
- Hacer hincapié en la importancia de un diagnóstico preciso para una gestión eficaz de los pacientes.
- Para orientar las decisiones de tratamiento basadas en el riesgo y el tipo de epilepsia.
Principales métodos:
- Historial detallado del paciente y examen físico.
- Estudios de laboratorio y imágenes cerebrales (IRM con protocolo de epilepsia).
- La electroencefalografía (EEG por sus siglas en inglés).
Principales resultados:
- Es esencial distinguir entre los tipos de convulsiones (sintomáticas agudas, no provocadas, epilépticas).
- El diagnóstico de epilepsia tiene importantes consecuencias médicas, sociales y emocionales.
- Las herramientas de diagnóstico específicas como el EEG y la RM son vitales para la evaluación del riesgo.
Conclusiones:
- Un diagnóstico preciso separa la epilepsia de otros tipos de convulsiones, guiando el tratamiento.
- La evaluación cuidadosa evita el tratamiento innecesario para los pacientes con convulsiones únicas.
- La selección de medicamentos antiepilépticos adecuados y el asesoramiento son vitales para los pacientes con epilepsia diagnosticada.
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