Latin American multicenter Prospective study of first epileptic crisis

Epilepsy, one of the most frequent neurological diseases worldwide, affects about 70 million people of all ages, most of them in underdeveloped countries. While all patients with epilepsy experience epileptic crises, not all people with epileptic crises have epilepsy, since it requires recurrence of epileptic crises to be called epilepsy. An acute symptomatic epileptic crisis (CESA) differs from epilepsy in several aspects: the near cessation cause is clearly identifiable and are not necessarily characterized by a tendency to recurrence, "unprovoked" epileptic crises are episodes that occur in the absence of a potentially responsible acute clinical condition. Although the cessation is an indisputable risk factor of epilepsy, they cannot be included in the definition of epilepsy, which is understood as the appearance of a "enduring" predisposition of generating crisis. The appropriate distinction between cessation and unprovoked crises is essential for treatment decisions and especially patient prognosis. The objective is to establish the differential diagnosis and the etiology of the first epileptic crisis, as well as the risk factors of crisis recurrence; That is, to develop epilepsy, in patients from Latin America, for which a prospective, multicenter, cohort study will be carried out, in a representative sample of patients who come to the emergency service of 10 hospitals from five Latinomerical countries, according to criteria of inclusion and exclusion, and the respective procedures and diagnostic criteria previously defined. Once the diagnosis has been confirmed, patients will be monitored for an additional year to identify the recurrence of crisis, the statistical analysis will be performed through the Student T test to compare continuous variables, chi-square to compare categorical variables and survival analysis of Kaplan-Meier to calculate the accumulated incidence of epilepsy to 1 year, comparing patients with cessation and patients with first crisis with first crisis. The proportional risks of COX will be used to examine the effect of a cessation compared to a first crisis not caused on the risk of epilepsy, controlling by age, sex, family history of epilepsy and stratifying by etiology of the first crisis.

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