Clasificación TEL de Rapin y Allen. Uploaded by. Javiera Fernanda Eyzaguirre García · fisioterapia_orofacial_y_de_reeducacion_de_la_deglucion. Non‐specialists can identify three types of developmental language disorder. (1) mixed receptive/expressive disorders, which impair phonology, syntax, and. Desde la clasificación de Rapin y Allen () han surgido algunas nuevas, como la de Crespo-Eguílaz y Narbona (), que diferen- cian tres subgrupos a .

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The Spanish Association of Pediatrics has as one of its main objectives the dissemination of rigorous and updated scientific information on the different areas of pediatrics.

Annals of Pediatrics is the Body of Scientific Expression of the Association and is the vehicle through which members communicate. The magazine, referring to the Spanish-speaking pediatric, indexed in major international databases: The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years.

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CiteScore measures average citations received per document published. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal’s impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

A study of epilepsy, according to the age at onset of the crisis and its causes, monitored by a Paediatric Neurology Unit over a period of three years. Historical cohorts study was conducted by reviewing the Paediatric Neurology medical casificacion database of epileptic children followed-up from 1 January to 31 December A total of children were attended during the study period.

The diagnosis of epilepsy was established in Absence epilepsy and benign childhood epilepsy with centro-temporal spikes are the idiopathic epileptic syndromes most prevalent, and the most prevalent symptomatic epilepsies are prenatal encephalopathies. More than one-quarter J epilepsy was observed in The absence of a universally accepted classification of epileptic syndromes makes tasks like this difficult, starting with the terminology.

A useful allwn would be aetiological, with two groups: The age of onset of epilepsy in each aetiological group helps in the prognosis, which is worsened by refractoriness and associated neurodevelopmental disorders, and are generally worse at an earlier onset and in certain aetiologies. Epilepsy is one of the most frequent neurologic disorders in childhood, dlasificacion an estimated prevalence of 3.

Epilepsy syndromes are age-dependent, and their characteristics vary based on the stage of brain maturation, with certain disorders presenting predominantly in specific age groups. The prognosis of epilepsy depends mainly on its aetiology.

Another key factor is the age at the first seizure which depends on the aetiologywith early ages generally associated with poorer outcomes. We conducted a clasiificacion of cases of epilepsy and epilepsy syndrome by age of onset and aetiology followed up at a regional reference paediatric neurology unit during a three-year period. We analysed aetiologic and prognostic differences rappin epilepsy by age of onset in the patients that received care in our unit during the period under study.

The population under study consisted of all patients aged more than 1 month with a diagnosis of epilepsy assessed for the first time or in follow-up visits at the Unit of Paediatric Neurology of the Hospital Miguel Servet of Zaragoza over a three-year period from January 1, to December t, The services clasiicacion by this unit since its creation in have been documented in an electronic database, that includes records of all the relevant data for each patient 11,12 that are updated when there are clinically relevant changes, new test results or changes in treatment.

We flasificacion a claisficacion cohort study by reviewing the medical records of the patients included in the sample. We have defined epilepsy as a history of at least two spontaneous epileptic seizures.


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The exclusion criteria included neonatal convulsions in the absence of subsequent epilepsy, isolated afebrile seizures, febrile seizures, and other acute provoked or symptomatic seizures. We have defined symptomatic epilepsy as epilepsy secondary to a brain abnormality and that manifests with seizures in addition to other neurologic manifestations. We developed our own classification scheme into aetiologic groups to facilitate our analysis: We defined idiopathic epilepsy as seizures that are not caused by a brain abnormality and constitute the main manifestation of disease in the absence of other associated neurologic signs and symptoms, with the assumption that these are genetic and age-dependent.

We defined cryptogenic epilepsy as epilepsy that cannot be classified as either idiopathic or symptomatic due to insufficient clinical and outcome data. The term cryptogenic was used based on its etymology: We assessed prognosis taking into account treatment effectiveness refractory disease and the impact on neurologic function.

Adhering to the definition of the International League Against Epilepsy ILAE14 we defined refractory epilepsy as failure of adequate trials of two tolerated and appropriately chosen and used antiepileptic drug schedules whether as monotherapies or in combination to achieve sustained seizure freedom. Subsequently, we assigned each patient one or several neurological functioning diagnosis of the following: We used the following tests in our statistical analysis: We defined statistical significance as a p -value of less than 0.

At the time of the study, the database of the unit had records for 15 patients.

During the period under study, patients had received care in the unit. Out of the total, had sought care for seizures Epilepsy was categorised as symptomatic in patients In the three years under study, new cases of epilepsy were diagnosed, while the rest of assessments corresponded to patients in follow-up.

Of all included patients, The mean duration cladificacion follow-up was 6.

The mean age of onset of epilepsy was 4. Gapin 1 shows the age of onset of epilepsy in age bands by aetiology. In our sample, The most prevalent aetiology in children with early onset was symptomatic Idiopathic epilepsy predominated in children with onset between 6 and 10 years of age Table 2 clasficacion the differences between the three aetiological groups by age of onset. Age of onset groups by aetiology of epilepsy. The absolute frequencies and percentages over the total sample of epilepsies in each age group are shown in bold.

Comparison of the age of onset of epilepsy by aetiology Kruskal—Wallis test with post hoc tests with Bonferroni correction. The result of the statistical test on the total cases of epilepsy in the sample is shown in bold. Table 3 summarises the incidence, prevalence and age of onset of idiopathic and cryptogenic epilepsy syndromes. Table 4 summarises the incidence, prevalence and age of onset of symptomatic epilepsies by aetiology. Prevalence, incidence and age of onset in years of idiopathic and cryptogenic epilepsy syndromes.

An additional genetic test for mutations in the SCN1A gene was performed in 34 patients and was positive clasificacoin 8, who are the patients with a diagnosis of Dravet syndrome. The cumulative data for the idiopathic and cryptogenic syndromes, and within the idiopathic, of generalised and focal syndromes, are shown in bold.

Prevalence, incidence and age of onset in years of symptomatic epilepsy syndromes. Of the two cases of genetic lissencephaly, one was due to a mutation in the LIS1 gene and the other to a mutation in the EN2 gene.

The cumulative data for the different aetiologic groups into which we classified the cases of symptomatic epilepsy are shown in bold. Table 5 shows the clinical presentation of epileptic seizures by age of onset of epilepsy. Focal seizures were more common Epilepsy presented as infantile spasms in Table 6 contrasts the age of onset of epilepsy with the type of seizure. Type of epileptic seizure by onset age group. The overall data for each different type of epileptic seizures relative to the total sample are shown in bold.

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Comparison of age of onset of epilepsy clasificacino type of seizure Kruskal—Wallis test with Bonferroni correction. The results of the statistical test for all cases of epilepsy in the sample are shown in bold. Table 7 summarises the prevalence of neurologic function disorders and refractory disease by age group. The mean duration of follow-up of refractory epilepsies was 8. The median age of onset was significantly lower in patients with refractory clasificaciln 1.

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Of the total sample, The younger the age of onset, the greater the percentage of refractory disease and of neurologic disorders: Functional neurological disorders and refractory epilepsy by age of onset of epilepsy. The absolute frequencies and percentages of the total sample of epilepsies in each age group are shown in bold. Table 8 compares the outcome characteristics by age of onset. Functional neurological disorders and refractory disease by age of onset of epilepsy Mann—Whitney U test.

After excluding patients with malignant intracranial tumours and brain malformations, 14 patients were considered eligible for surgery to treat refractory epilepsy, and five finally underwent surgical intervention: One of the patients with cortical dysplasia experienced a significant decrease in the frequency of seizures, and in the other four the seizures disappeared after the intervention although one of the patients with cortical dysplasia experienced a relapse that was refractory to treatment two years later.

The classification of epilepsy syndrome remains unresolved since15 as the classification proposed by the ILAE in 16 has not been widely accepted, which poses challenges to the definition and delimitation of syndromes, and to the comparison of case data.

This new proposal by the ILAE was met with considerable criticism by epilepsy specialists, 17—19 as rather than offering a new classification it seemed to offer a new terminology. Thus, the classification does not accept the subdivision into generalised and focal epilepsy, although it does maintain the division between epileptic seizures of either type, while eliminating the concepts of idiopathic, symptomatic and presumed symptomatic epilepsy. Epilepsy syndromes are age-dependent and their clinical and electroencephalographic characteristics vary based on the stage of brain maturation, 7,20,21 as demonstrated in this study.

In our sample, the onset of Furthermore, the median age of onset of symptomatic epilepsies was 1. The incidence of some epilepsy syndromes peaks at certain ages. In our sample, West syndrome, Ohtahara syndrome, Dravet syndrome or benign partial epilepsy in infancy had onsets in the first months of life, while absence seizures, benign childhood epilepsy with centrotemporal spikes and other forms of idiopathic generalised epilepsy appear in school-aged children.

In the group of symptomatic epilepsies, some aetiologies are associated with onset in the first year of life, such as genetic lissencephaly, Down syndrome, hypoxic-ischaemic encephalopathy or tuberous sclerosis, while others are associated with onset at later ages. In our study, focal seizures One of the factors that are associated with unresponsiveness to treatment is the age of onset, with refractory epilepsy occurring more frequently in cases with onset at earlier ages first two to three years of life.

Out of all cases of epilepsy with onset before age 1 year, Several publications have emphasised that the cognitive sequelae of epilepsy become more significant the lower the age of onset. In the group of patients with onset between ages 1 and 3 years, It seems that the factor that has the strongest impact on cognitive development in the early stages of life is the aetiology of the epilepsy.

Therefore, these patients usually have neurodevelopmental comorbidities.