Tabla I. Factores clínicos y sociodemográficos de pacientes con epilepsia mioclónica juvenil (n = 145). |
|||
n |
% |
||
Sexo |
Femenino |
87 |
60 |
Masculino |
58 |
40 |
|
Edad |
26 a |
21-38 b |
|
Escolaridad |
Analfabetismo |
2 |
1,4 |
Primaria incompleta |
13 |
9 |
|
Primaria completa |
19 |
13,1 |
|
Secundaria incompleta |
39 |
26,9 |
|
Secundaria completa |
53 |
36,6 |
|
Universitaria |
19 |
13,1 |
|
Estrato socio-económico |
Estrato I |
32 |
22,1 |
Estrato II |
75 |
51,7 |
|
Estrato III |
29 |
20 |
|
Estrato IV |
4 |
2,8 |
|
Estrato V |
4 |
2,8 |
|
Estrato VI |
1 |
0,7 |
|
Edad de inicio de la epilepsia |
14 a |
12-16 b |
|
Número de crisis al mes |
3 a |
0,4-12 b |
|
Factores precipitantes |
39 |
26,9 |
|
Antecedentes psiquiátricos |
13 |
9 |
|
Antecedentes de consumo de sustancias psicoactivas |
34 |
23,4 |
|
Antecedentes familiares de epilepsia |
70 |
48,3 |
|
Antecedente de traumatismo craneoencefálico |
35 |
24,1 |
|
Farmacorresistencia |
7 |
4,8 |
|
a Mediana; b Rango intercuartílico. |
Tabla II. Factores clínicos y sociodemográficos asociados con el control de las crisis (n = 45). |
||||
No control |
Sí control |
Odds ratio |
p |
|
Sexo |
33 (64,7%) |
54 (57,4%) |
1,36 (0,67-2,75) |
0,394 |
Edad a |
26 (21-45) |
27 (20-35) |
– |
0,318 c |
Estrato socioeconómico bajo |
49 (96,1%) |
87 (92,6%) |
1,97 (0,39-9,86) |
0,401 |
Escolaridad baja |
11 (21,6%) |
23 (24,5%) |
0,85 (0,37-1,92) |
0,694 |
Edad de inicio de la epilepsia a |
14 (13-16) |
14 (12-15) |
– |
0,136 c |
Número de crisis al mes a |
1 (0,16-5) |
4 (1-16) |
– |
0,033 c |
Factores precipitantes |
13 (25,5%) |
26 (27,7%) |
0,85 (0,41-1,94) |
0,778 |
Antecedentes psiquiátricos |
5 (9,8%) |
8 (8,5%) |
1,16 (0,36-3,77) |
0,795 |
Antecedentes de consumo de SPA |
18 (35,3%) |
16 (17,0%) |
2,66 (1,21-5,84) |
0,013 |
Antecedente familiar de epilepsia |
24 (47,1%) |
46 (48,9%) |
0,93 (0,46-1,83) |
0,829 |
Antecedente de TCE |
10 (19,6%) |
25 (26,6%) |
0,67 (0,29-1,54) |
0,348 |
Farmacorresistencia |
7 (13,7%) |
0 |
3,13 (2,45-4,00) |
0,001 |
IC 95%: intervalo de confianza al 95%; SPA: sustancias psicoactivas; TCE: traumatismo craneoencefálico. a Mediana (rango intercuartílico); b χ2 de independencia de Pearson; c U de Mann-Whitney. |
Tabla III. Valoración de condicionantes de recaída y su asociación con el control de las crisis (n = 145). |
||
Odds ratio (IC 95%) a |
p |
|
Educativo |
0,72 (0,14-3,88) |
0,708 |
Económico |
1,91 (0,46-8,00) |
0,366 |
Ausencia familiar |
3,80 (0,33-42,91) |
0,248 |
Comorbilidades |
2,83 (0,85-9,43) |
0,079 |
Plan de salud |
12,64 (3,45-46,30) |
0,001 |
Acceso a los medicamentos |
2,87 (1,29-6,37) |
0,008 |
Contexto domiciliario |
0,60 (0,11-3,08) |
0,535 |
Actitudes personales |
4,39 (2,07-9,31) |
0,001 |
IC 95%: intervalo de confianza al 95%; a χ2 de independencia de Pearson. |
Tabla IV. Factores explicativos del control de crisis en pacientes con epilepsia mioclónica juvenil. |
||||
B |
ORa a |
IC 95% |
p |
|
Número de crisis al mes |
–0,054 |
0,94 |
0,90-0,99 |
0,026 |
Antecedente de consumo de sustancias |
0,62 |
1,86 |
0,65-5,28 |
0,244 |
Condicionante de plan de salud |
2,935 |
18,81 |
2,69-131,58 |
0,003 |
Condicionante de actitudes personales |
1,11 |
3,04 |
1,13-8,14 |
0,027 |
Condicionante de acceso |
–0,122 |
0,86 |
0,22-3,61 |
0,865 |
Condicionante de ausencia familiar |
1,056 |
2,87 |
0,12-68,94 |
0,515 |
IC 95%: intervalo de confianza al 95%; ORa: odds ratio ajustada. a Regresión logística binaria. |
Clinical and psychosocial factors associated with seizure control in patients with juvenile myoclonic epilepsy Aim. To identify the clinical and psychosocial factors of a Colombian cohort of patients with juvenile myoclonic epilepsy and its relation to crisis control. Patients and methods. Retrospective cohort study of patients over 14 years of age with a diagnosis of juvenile myoclonic epilepsy, with 12 months of follow-up in an epilepsy program, where the sociodemographic and clinical characteristics and the survey for the assessment of relapse conditioners. A bivariate and multivariate analysis was performed using binary logistic regression. Results. Clinical records between November 2014 and December 2016 where 145 patients with a diagnosis of juvenile myoclonic epilepsy who met the selection criteria were evaluated. The factors associated with crisis control were: health plan, accessibility, personal attitudes, history of consumption, drug resistance, and crisis number per month; of these, health plans, personal attitudes, and crisis number per month persist with statistical significance after the logistic regression analysis. Conclusion. Psychosocial factors not only impact on crisis control, added to clinical factors explain 40% of crisis control in patients with juvenile myoclonic epilepsy and therefore affect their long-term prognosis. Key words. Convulsions. Epidemiological studies. Generalised epilepsy. Juvenile myoclonic epilepsy. Risk factors. Socioeconomic factors. |