Etiologies of Epilepsy Within the Multicenter EPICO Cohort in Lima, Peru
Abstract number :
1.548
Submission category :
16. Epidemiology
Year :
2024
Submission ID :
1456
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Sofía Guevara-Lazo, BS – School of Medicine, Universidad Peruana Cayetano Heredia
Eliane Rivas-Leiva, BS – Medicine Faculty, Universidad Científica del Sur
Samuel Eitenbichler, BS – Icahn School of Medicine at Mount Sinai
Liza Núñez Del Prado Murillo, MD – Instituto Nacional de Ciencias Neurológicas
Carlos Alva-Díaz, MD – Hospital Nacional Daniel Alcides Carrión
Wilfor Aguirre-Quispe, MD – Universidad Científica del Sur
Monica Diaz, MD – University of North Carolina at Chapel Hill
Sofía Sánchez-Boluarte, MD – Instituto Nacional de Ciencias Neurologicas
Rationale: Epilepsy is a prevalent disease worldwide, affecting approximately 50 million people globally, with 80% living in Low-Middle-Income countries (LMIC). Currently, there is limited information about the most common etiologies of epilepsy in Latin America. In the present study, the most frequent etiologies of epilepsy and their association with drug-resistant epilepsy was determined.
Methods: We performed a cross-sectional analysis of the etiologies identified during a baseline evaluation within a multicenter, cohort study (Epilepsy Cohort [“EPICO”]) which included adults with epilepsy, 18 years or older, in four hospitals in Lima, Peru. Drug-resistant epilepsy was defined as patients who continued to have seizures despite having had adequately tried at least two medication regimens in the past. The general etiologies identified were structural, infectious, autoimmune, metabolic, vascular, genetics, and neurodegenerative.
Results: A total of 316 adult patients (median age = 29 years, IQR: 23-40) were enrolled in the study. Among them, 173 patients (54.7%) had a structural etiology. Of these patients, the most common conditions were hippocampal sclerosis (32 patients, 10.1%), malformations of cortical development (21 patients, 6.6%), and encephalomalacia (17 patients, 5.4%). Drug-resistant epilepsy (DRE) was identified in 144 patients (45.6%), the majority of which had a structural etiology (93 patients, 64.6%) causing their epilepsy. Among patients with DRE, 23 of them (16%), had been found to have hippocampal sclerosis.
Conclusions: Structural etiologies, particularly hippocampal sclerosis, is common among people with epilepsy in Peru, and it is strongly associated with drug-resistant epilepsy. Identifying these underlying etiologies could be key in guiding treatment strategies for better management of patients with DRE in the future.
Funding: Diversity Innovation Hub at Mount Sinai, Fogarty International Center, Universidad César Vallejo, American Academy of Neurology
Epidemiology