Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- deficits neurológicos focais
- sintomas neurológicos focais (antes ou depois da convulsão)
- sensação ou experiência premonitória (medo, sensação epigástrica, déjà vu, jamais vu)
- hemiparesia temporária
- afasia temporária
- febre, rigidez da nuca, estado mental alterado
Fatores de risco
- história familiar (estendida ou imediata) de epilepsia de início generalizado
- Infecção prévia do sistema nervoso central (SNC)
- trauma cranioencefálico
- eventos convulsivos prévios ou suspeita de eventos convulsivos
- História de abuso de substâncias
- nascimento prematuro
- convulsões febris múltiplas ou complicadas
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- eletroencefalograma (EEG)
- glicose sanguínea
- Hemograma completo
- painel de eletrólitos
- análise toxicológica
- tomografia computadorizada (TC) de crânio
Investigações a serem consideradas
- punção lombar
- ressonância nuclear magnética (RNM) cranioencefálica
- prolactina sérica
- creatina quinase (CK) sérica
Algoritmo de tratamento
Colaboradores
Autores
Abdulrahman Alwaki, MD
Assistant Professor of Neurology
Emory University School of Medicine
Atlanta
GA
Declarações
AA is a Site Principal Investigator for an EPAS (Epilepsy Post Approval Study) for deep brain stimulation funded by Medtronic and receives 1% salary support.
Daniel Winkel, MD
Assistant Professor of Neurology
Emory University School of Medicine
Atlanta
GA
Declarações
DW states that he has no competing interests.
Agradecimentos
Dr Abdulrahman Alwaki and Dr Daniel Winkel would like to gratefully acknowledge Dr Vikram R. Rao, Dr John D. Hixson, and Dr Daniel H. Lowenstein, previous contributors to this topic.
Declarações
VRR has served as a paid consultant for NeuroPace, Inc., manufacturer of the Responsive Neurostimulation (RNS) System. VRR is also an author of several references cited in this topic. JDH has received research funding and consultancy funds from UCB Inc. DHL declares that he has no competing interests.
Revisores
Edward Barry Bromfield, MD
Chief
Division of Epilepsy and Sleep
Department of Neurology
Brigham and Women's Hospital
Associate Professor of Neurology
Harvard Medical School
Boston
MA
Declarações
EBB has received speaking fees from ICR Pharma, Novartis, Abbott Laboratories, GlaxoSmithKline, and Pfizer. He has received consulting fees from ICR Pharma, Genzyme, and Spherics, and research funding from UCB Pharma. Unfortunately we have since been made aware that EBB is deceased.
Roderick Duncan, MD, PhD, FRCP
Honorary Clinical Senior Lecturer
University of Glasgow
Institute of Neurological Sciences
Glasgow
UK
Declarações
Not disclosed.
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