Authors :
Presenting Author: Olga Cuero Vidal, Master – CUNY Graduate School of Public Health and Health Policy, City University of New York, NY, USA
Arturo Carpio, MD – Hospital Santa Ines, Universidad de Cuenca , Ecuador
Vanessa Alexandra Solis Cabrera, BS – Hospital Santa Ines, Universidad de Cuenca , Ecuador
Lilia Nuñez, MD – Hospital 20 de Noviembre, Mexico
Noel Plascencia Alvarez, MD – Hospital 20 de Noviembre, Mexico
Pedro Briseño, MD – Hospital 20 de Noviembre, Mexico
Pedro Hamamoto, MD – Faculdad Medicina de Botucatu, Brasil
Eduardo Rezk, MD – Faculdad Medicina de Botucatu, Brasil
Mariana Pinheiro, MD – Faculdad Medicina de Botucatu, Brasil
Agnes Fleury, MD – Instituto Nacional de Neurología y Neurocirugía de México
Roberto Suastegui, MD – Instituto Nacional de Neurología y Neurocirugía de México
Andrea Gaytán, MD – Instituto Nacional de Neurología y Neurocirugía de México
David Rios Patiño, MD – Universidad Nacional Autónoma de México
Andrés Morcillo Muñoz, MD – Universidad Nacional Autónoma de México
Daniela DiCapua, MD – Hospital Eugenio Espejo, Ministerio de Salud Pública, Quito, Ecuador
Elena Mullo, MD – Fundación Liga Central Contra La Epilepsia, Colombia
Patricia Braga, MD – Universidad San Francisco de Quito, Ecuador
Elisa Demicheli, MD – Universidad San Francisco de Quito, Ecuador
Federico Preve, MD – Hospital de Clínicas de Montevideo
Enrique Monllor, MD – Hospital de Clínicas de Montevideo
Brenda Giagante, MD – Hospital San Juan de Dios de La Plata, Argentina
Manuela Villanueva, MD – Hospital de Alta Complejidad El Cruce “Néstor Kirchner”. ENyS. CONICET. Florencio Varela. Argentina
Juan Jerez, MD – Hospital de Alta Complejidad El Cruce “Néstor Kirchner”. ENyS. CONICET. Florencio Varela. Argentina
José Antonio Zambrano, MD – Hospital de Alta Complejidad El Cruce “Néstor Kirchner”. ENyS. CONICET. Florencio Varela. Argentina
Florencia Andrieu, MD – Hospital San Juan de Dios de La Plata, Argentina
Stephanie Pino Salgado, MD – Hospital San Juan de Dios de La Plata, Argentina
Vanessa Gomez Gulfo, MD – Hospital San Juan de Dios de La Plata, Argentina
Arturo Márquez, MD – Hospital Dr. Sótero del Río, Chile
Reinaldo Uribe, MD – Hospital Dr. Sótero del Río, Chile
Ledda Aguilera, MD – Hospital Clínico de la Universidad de Chile
Alonso Quijada, MD – Hospital Clínico de la Universidad de Chile
Gabriela Abudinen, MD – Hospital Clínico de la Universidad de Chile
Julia Rivas, MD – Hospital Interzonal General de Agudos Prof. Dr. Rodolfo Rossi de La Plata, Argentina
Luis Rivas, MD – Hospital Interzonal General de Agudos Prof. Dr. Rodolfo Rossi de La Plata, Argentina
Luis Mario Piedra, MD – Hospital Santa Inés, Universidad de Cuenca, Ecuador
Elizabeth A Kelvin, PhD – CUNY Graduate School of Public Health and Health Policy, City University of New York, NY, USA
Rationale:
Active epilepsy is when a person diagnosed with epilepsy has had a seizure within the past 5 years, regardless of treatment, or who is currently receiving antiseizure medication, regardless of seizures (1). The etiology of epilepsy influences the course of the disease, prognosis, and treatment. Information regarding etiology is limited in Latin America. This study aimed to describe the causes of active epilepsy in Latin American countries.
Methods:
We conducted a regional, multicentric case series in which data were collected between March 1st and December 30, 2024, from medical records of patients aged 16 years and older who had received an epilepsy diagnosis and experienced at least one seizure between January 2020 and December 2024 in 15 neurology clinics across seven Latin American countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico and Uruguay). Demographic characteristics, medical and neurological conditions, electroencephalogram (EEG) findings, imaging results, and treatment information were obtained. The statistical significance of the difference was assessed with the chi-square (χ2) or Fisher's exact test.
Results:
Overall, 3,037 patients with active epilepsy were identified. The mean age at diagnosis was 32+19.1 years, and 53.1% of the cases were women. Most (97.2%) lived in urban areas, and 63.7% had secondary school education or less. Family history of epilepsy was reported by 12.6%, and 43.3% of patients were currently under monotherapy, 29.7% with pharmacoresistant epilepsy.
More frequent etiologies were structural (46.3%), unknown (35%), and genetic (10.4%). Only 5.4% of cases were due to infectious diseases. Among structural etiologies, 11.7% had hippocampal sclerosis (HS), 11.2% had brain malformations (MCD), and 8.4% had stroke. The most common cause among males was MCD (23%), whereas HS was most common among females (29.2%, χ2 p = 0.03). In patients aged ≤64 years, HS and MCD were the most common causes observed in 27.7% and 27.0% of cases, respectively. Conversely, in individuals aged ≥65 years, stroke emerged as the main structural etiology (53.2%, χ2 p < 0.001).