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M Vázquez López

Publications and source records attributed to M Vázquez López.

11 recordsLinked to original sources
PubMed2000

Seizure recurrence after a first unprovoked seizure in childhood: a prospective study.

PURPOSE: To study the risk of recurrence after a first unprovoked seizure in childhood. METHODS: All consecutive patients aged less than 14 years with one or more unprovoked seizures who were attended between January 1, 1987, and June 1, 1996, were included in a prospective study. Clinical features of patients attended after a first seizure and those attended after two or more seizures were compared. Recurrence risk in both groups was estimated by Kaplan-Meier curves. Univariate and multivariate analyses of the potential predictors of recurrence risk were performed for the group of patients attended after a first seizure using the Cox proportional hazards model. RESULTS: Included in the study were 217 children. Kaplan-Meier estimate of recurrence risk was 64% at 5 years, when only patients being attended after a first epileptic seizure were included, compared with 74% when all patients were included. Significant differences in several clinical features were found between patients attended after a first seizure and those attended after two or more seizures. Univariate and multivariate analyses showed that in the overall cohort of patients attended after a first seizure, a symptomatic etiology increased the risk of recurrence, whereas a patient age of 3 to 10 years decreased this risk. In particular, the recurrence risk was 96% at 2 years for symptomatic seizures, compared with 46% for idiopathic/cryptogenic seizures. In the group of patients with idiopathic/cryptogenic seizures, an abnormal electroencephalogram and the occurrence of seizures during sleep increased the recurrence risk, whereas a patient aged 3 to 10 years reduced it. In the group of patients with symptomatic etiology, univariate analysis revealed that there was a lower recurrence risk for patients aged 3 to 10 years. This last finding was not maintained, however, in multivariate analysis. CONCLUSIONS: The recurrence risk depends on the inclusion criteria for enrolling patients. Several factors enable us to predict the recurrence risk after a first unprovoked seizure; the most important of these factors is the etiology of the seizures.

Adolescent↗
PubMed1996

[A score for the differential diagnosis of bacterial and viral meningitis].

The purpose of this study was to verify the statistical validity of the score proposed by Thomé et al. for the differential diagnosis between bacterial and viral meningitis and to study the utility of two new parameters (CRP and the patient's age). A retrospective review of 136 consecutive cases of meningitis was made. The cases were classified into three groups according to the culture results and the use or not of intravenous antibiotics. There were 20 cases of bacterial meningitis, 60 non-bacterial and 56 cases of meningitis of uncertain etiology. Considering only the patients in the first two groups, the capacity for differential diagnosis between bacterial and non-bacterial meningitis of the 8 parameters in the original score, the CRP and the patient's age was analyzed with a numeric value of 0, 1, or 2 assigned to each parameter. Finally, the results of applying the score that includes the two new parameters with the original score are compared. We found that all parameters showed statistical significance for the differential diagnosis between bacterial and viral meningitis. The resulting score can be used in order to decide the need for intravenous antibiotic therapy, with only a few cases being uncertain. The score with the two new parameters correctly classified 78 of the 80 cases, while leaving only two case uncertain as compared to the four that remained unclassified with the original score. We conclude that the score is a useful instrument in the differential diagnosis between bacterial and viral meningitis. Furthermore, the introduction of CRP and the patient's age improves the diagnostic value of the test.

Adolescent↗
PubMed1996

[Epidemiology of epilepsy in pediatric age: types of epileptic crises and epileptic syndromes].

OBJECTIVES: 1. To study the epidemiological characteristics and types of epileptic seizures in infancy. 2. To evaluate our experience with the ILAE classification of epilepsies and epileptic syndromes and to study the relative frequency of the different epileptic syndromes. PATIENTS AND METHODS: All patients under 14 years of age that were evaluated for one or more unprovoked seizures in a primary care hospital between January 1, 1988 and June 1, 1994 were prospectively included in the study. In the 151 patients that met these criteria, we studied the epidemiological characteristics, predominantly the type of seizure and the classification as to type of epileptic syndrome. RESULTS: 1. ETIOLOGY: Of all of the seizures, 18% were considered symptomatic with a predominance in the first three years of life (34%), 28% were idiopathic with the predominance of cases occurring over three years of age (34%) and 54% cryptogenic, with an even distribution in all age groups. 2. Epileptic seizure type: Patients under 3 years old had 17% generalized epilepsies, 20% localization-related, 31% undetermined and 31% isolated seizures. In the 4-9 year olds, had 12%, 51%, 4%, and 32%, respectively. Between 4-14 years of age, benign rolandic epilepsy accounted for 17% of the epilepsies. Sixty-two percent of the patients remained classified in nonspecific categories (26% isolated seizures, 16% undetermined and 20% cryptogenic localization-related). CONCLUSIONS: The study of unprovoked seizures in children shows marked differences in the different age groups in respect to epileptic seizure type, etiology and epileptic syndrome classification. The application of the ILAE classification system leaves the majority of patients in non-specific categories.

Adolescent↗