Avaliação do perfil clínico-epidemiológico e do manejo terapêutico de pacientes com epilepsia no ambulatório de neurologia do Centro de Especialidades Médicas do CESUPA (CEMEC) no período de 2014-2018: um estudo retrospectivo

Abstract

Introduction: Epilepsy is one of the most common neurological diseases and is accompanied by neurobiological, cognitive, psychological and social consequences. Most people with epilepsy in developing countries are not receiving treatment, directly increasing health costs and reducing quality of life. Objective: To evaluate the clinical-epidemiological profile and therapeutic management of patients with epilepsy at the CEMEC-CESUPA Neurology Outpatient Clinic in 2014-2018. Methodology: This is a cross-sectional, retrospective, descriptive and analytical study of medical records analysis. The research sample consisted of 69 patients diagnosed with epilepsy, aged 15 years and older, treated at the Neurology Outpatient Clinic of CEMEC-CESUPA, from 2014 to 2018. Data analysis was performed using BioEstat 5.4 software (AYRES et al, 2015). Results: The sample profile showed that there is no significant difference between the number of patients by gender, so there is a frequency of 52.2% male patients and 47.8% female, ages 16 to 25 years (36.2%), most of them single (69.6%), students (29%) and from the capital (60.9%). Most of the patients had the onset of seizures up to 5 years old (24.6%), began treatment after the first seizure (46.4%) and had a frequency of seizures between 1-2 times a months (37.7%). The crises are generalized tonic-clonic (65.2%), the main triggering factors of the crises are: forget the medication (71.1%) and stress (48.9%). It was noted that the most relevant etiology of the study was the unknown (59,4%), followed by the structural etiology (34,8%). In addition, 56.5% of the patients in the sample have comorbidities, being the mental disorders predominant (37.7%) and only 20.3% of the patients have family history of epilepsy. Most patients had initial therapeutic management with monotherapy (62%), with carbamazepine (35,4%) and phenobarbital (31,4%) standing out. Only 40.6% of the patients had an association of medication, but this proportion was not significant. For most of the patients (73.9%) there was no drug exchange. 26.1% of the patients had side effects, being drowsiness (38.9%) the main one. Moreover, it is verified that the majority of the patients took up to 1 year to control the crises (30.4%) and 27.5% could not control the crises. Conclusion: Among the main benefits of this study, the contribution of clinical-epidemiological analysis and therapeutic management of patients with epilepsy is noteworthy, aiming at elaborating strategies for adherence of patients seen in this outpatient clinic and adequate control of epileptic seizures in order to improve the quality of life of these patients in the short and long term.