Arq Neuropsiquiat r 2002;60(4):1048-1052
THESES
DEVELOPM ENT OF TARGET CENTERED ARC APPARATUS FOR NEUROSURGICAL STEREOTACTIC PROCE-DURES (ABSTRACT)* . THESIS. RIO DE JANEIRO, 2002.
CESAR FANTEZIA ANDRAUS* *
URBAN PREVALENCE OF EPILEPSY: A STUDY OF THE POPULATION OF SÃO JOSÉ DO RIO PRETO - BRAZIL (ABSTRACT)* . THESIS. SÃO JOSÉDO RIOPRETO, 2002.
M OACIR ALVES BORGES * *
Int roduct ion. The purpose of t his st udy w as t o sur-vey t he prevalence of epilepsy in t he urban populat ion of São José do Rio Pret o, a m edium -sized cit y, 360,000 inhabit ant s, at nort hw est of São Paulo st at e, Brazil.
Method: This population cross-sectional epidemiolo-gical st udy w as carried out int o t w o st ages. The first w as t o access validat ion of t he screening quest ionnaire on a neighborhood of the city; the second w as the study of t he prevalence in a random ly, st rat ified large-scale survey on t he populat ion of t he cit y. A gold st andard prot ocol, clinical hist ory and neurological examinat ion, w as used t o diagnose all t he posit ive cases. The false negat ive cases w ere obt ained aft er t he validat ion of result s by a m at hem at ical m odel. For assessing preva-lence Chi-square t est and Confidence Int erval (CI 95%) w ere used t o analyze t he result s (p-value ≤ 0.05).
Result s: The Validat ion of t he screening quest ion-naire show ed a sensit ivit y of 95.83% and a specificit y of 97.8%. There w ere 17,293 individuals in t he st udied sam ple; t he dist ribut ion according t o sex, age group and race w as sim ilar t o t he general populat ion. Lifet i-m e crude prevalence of epilepsy w as 18.6/1000 inh. (CI 95%;16.6-20.6); 8.2(CI 95%;6.8-9.5) for act ive and
10.4(CI 95%;8.9-11.9) of inact ive ( considering at least one seizure in t he last t w o years). The prevalence w as 4.9(CI 95%;3.9-6.0) in t he age group of 0 t o 4 years old; 11.7 (CI 9%;10.0-13.3), 5 t o 14 years old; 20.3 (CI 95%;18.2-24.4), 15 t o 64 years old ; and 32.8 (CI 95%;30.1-35.4), over 65 years old. The prevalence on t he A economic class w as 3.6(CI 95%;2.2-4.5), B, 9.0(CI 95%;7.6-10.5), C, 21.6(CI 95%;19.4-23.8), D, 26.3(CI 95%;24,0-28.7) and on E, 10.6(CI 95%;9.0-12.9) . The prevalence of part ial seizures w as 14.0(CI 95%;12,2-15,7). The prevalence of cryptogenic seizure w as 10.4(CI 95%;8.9-11.9).
Conclusion: The prevalence lifet im e and act ive epi-lepsy w as high; sim ilar t o som e developing count ries, such as t he ones of Lat in Am erica. The prevalence of epilepsy in childhood w as low ; w hile in t he elderly w as high, similar t o developed count ries. The lifet ime preva-lence w as great ly associat ed w it h t he econom ic st at us classes. These result s show ed t hat t he prevalence of epilepsy in São José do Rio Pret o has charact erist ics of developed and developing count ries.
KEY W ORDS: epilepsy, epidem iology, prevalence, Lat in America.
* Prevalência urbana da epilepsia: est udo populacional na cidade de São José Do Rio Pret o - Brasil (Resumo). Tese de Dout orado, Faculdade de M edicina de São José do Rio Pret o (FAM ERP) (Área: Ciências da Saúde, Epidemiologia).Orient adora: Dirce M aria Trevisão Zanet t a.
* * Ad d ress: Ru a Nair d o s San t o s Lim a 110, 15090-290 São Jo sé d o Rio Pret o SP, Brasil E-m ail: m o acirab @h o t m ail.co m ; moacirb@w est net .com.br
The neurosurgical st ereot act ic procedures present s prom inence in m odern neurosurgey, f or it s accuracy and m inim ally invasive charact er. St ereot act ic localiza-t ion is essenlocaliza-t ial localiza-t o perf orm w ilocaliza-t h precision inlocaliza-t racranial biopsies, guided craniot omies, nervous t issues ablat ion for movement disorders and pain t reat ment , cat het he-res and endoscope placem ent , and like a guide for ra-diosurgery. The t arget cent ered arc apparat us (isocen-tric) for neurosurgical stereotactic procedures have been
t he m ost used f or t he t w o last decades in t he w hole w orld.
