engleski

Diagnosing epilepsy syndrome in hospitalized patients

Epileptic seizures present a relatively frequent cause for hospitalization in Neurologic departments as a leading symptom of some neurologic disease or of general dysfunction, or because of the recent clinical deterioration in previously diagnosed patients with epilepsy. The reason for the admission may be an emergency treatment or clarification of the underlying pathology, possibly necessitating specific or radical management (surgery). All the patients with epileptic seizures admitted to the Department during the 3 years ( 1993-1995) were analyzed in respect of the diagnosis, the cause and type of seizure and the diagnostic procedures used, having in mind the difficult situation of medical service in the city under the siege. Altogether 139 patients (5, 75%) with epileptic seizures were admitted from the total of 2419 patients treated in the Department in this period. From the 139 hospitalized patients in 107 (76, 09%) some structural abnormality was diagnosed, mostly by CT or angiography, as a cause for seizure: congenital malformation or arachnoid cyst (3), arteriovenous malformations (3), stroke (49), consequences of brain trauma (10), primary ( 11 ) or metastatic (6) cerebral neoplasms, brain atrophy (6), chronic alcoholism ( 18), CNS infection ( 1 ). In 4 patients various other non primary cerebral factors were diagnosed as a possible cause for seizure (hypertensive crisis -1, sarcoidosis -l, multilple sclerosis -l, psychiatric patient on lithium therapy -1 ). In 7 patients the diagnosis "idiopathic epilepsy" was stated, while in 21 the etiology was not solved, resp. the noncompliance due to shortage of AED was suspected). Careful history analysis and meticulous neurologic examination, supported by EEG data and if necessary by ultrasonographic and brain scintigraphy analyses may help in the choice of patients which have the absolute priority in referral to CT or angiography, especially in the situations of restricted-diagnostic facilities.

epilepsy syndrome; diagnosis

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