Historia de la Liga Chilena contra la Epilepsia (LICHE). Conmemorando sus 70 años / History of the Chilean League against Epilepsy. 70 anniversary

La Liga Chilena contra la Epilepsia (LICHE), es una corporación sin fines de lucro, dedicada a apoyar a los pacientes con epilepsia y su entorno, educar en epilepsia, solidarizar con ellos en los aspectos psicosociales y socioeconómicos, procurándoles una mejor calidad de vida. Es parte del capítulo del International Bureau for Epilepsy (IBE). Cumple 70 años de labor y en este artículo se expone su historia y trayectoria, siendo un ejemplo mundial de manejo integral de pacientes con epilepsia y el impacto en la comunidad.

The Chilean League against Epilepsy (LICHE), a non-profit corporation, dedicated to supporting patients with epilepsy and their environment, educating in epilepsy, solidarity with them in psychosocial and socioeconomic aspects, worrying about a better quality of life. It is part of the chapter of the International Bureau for Epilepsy (IBE). It celebrates 70 years of work and this article exposes its history and trajectory, being a world example of integral management of patients with epilepsy and the impact on the community

Epilepsia no período gravídico-puerperal / Epilepsy in puerperal-pregnancy period

A epilepsia, doença cerebral caracterizada pela predisposição à geração de crises epilépticas, representa a patologia neurológica grave mais frequente na gravidez. Quando não acompanhada corretamente, possui um acentuado nível de morbimortalidade materno-fetal, sendo especialmente relacionada a riscos de convulsão materna na gestação e malformações fetais. Este artigo discute o acompanhamento da gestante epiléptica, trazendo recomendações de cuidados no período pré-concepcional, manejo durante o pré-natal, condução do trabalho de parto, peculiaridades no puerpério e tratamento de crises convulsivas, quando necessário. Serão abordados tanto aspectos de tratamento farmacológico quanto de monitoramento e orientações gerais, com o objetivo de contribuir para um suporte mais abrangente e adequado a esse grupo mais vulnerável de pacientes sob o cuidado do médico ginecologista-obstetra e neurologista.(AU)

Epilepsy, which is a brain disease defined for a greater predisposition for epileptic crisis, represents the most frequent neurological pathology during pregnancy. Without proper monitoring it is related to high morbidity and mortality to both mother and baby, especially due to the risks of mother seizure during pregnancy and fetus malformation. This article discusses about health care giving and follow-up for the epileptic pregnant women, pointing recommendations for preconception care, prenatal management, labor conduct, peculiarities in puerperium and treatment of convulsive crisis when needed. There will be approached pharmacological and non-pharmacological aspects, such as follow up exams and general orientations, having as a goal to contribute to an more abrangent and proper support of this more vulnerable group of patients under the care responsibility of obstetrician-gynecologist ad neurologist doctors.(AU)

Epilepsia asociada al accidente cerebrovascular / Post-stroke epilepsy

El accidente cerebrovascular (ACV) es la causa más común de convulsiones y epilepsia observada en estudios poblacionales de adultos. Las convulsiones ocurren dentro de las 24 horas posteriores al ACV en un alto porcentaje de pacientes. La patogénesis de estas convulsiones de inicio temprano puede estar relacionada con cambios iónicos locales y liberación de altos niveles de neurotransmisores excito-tóxicos en el área lesionada. Una lesión permanente con cambios en la excitabilidad neuronal parece ser responsable de convulsiones de inicio tardío después del ACV. Los factores de riesgo más comúnmente identificados con el comienzo agudo o tardío de las convulsiones post ACV son la gravedad y la localización cortical. La mayoría de las convulsiones post ACV son focales al inicio pero pueden generalizarse secundariamente, el estatus epiléptico es poco frecuente. La eficacia de las drogas antiepilépticas para estas convulsiones no ha sido rigurosamente evaluada en estudios controlados, aunque la mayoría de las convulsiones pueden ser controladas con un solo agente. Dada la frecuencia relativamente baja de convulsiones recurrentes después del ACV y la ausencia de predictores absolutos de epilepsia post ACV, la decisión de cuándo tratar a los pacientes con una convulsión después de un ACV es difícil.

Stroke is the most common cause of seizures and epilepsy in population stuies of adults. Seizures occur within 24 hours of the stroke in a high percent of patients. The pathogenesis of these early-onset seizures may be related to local ion shifts and release of high levels of excitotoxic neurotransmitters in the area of ischemic injury. The risk of late-onset seizures may increase over time, an underlying permanent lesion that leads to persistent chnges in neuronal excitability appears to be responsible for late-onset seizures after stroke. The most consistently identified risk factors for acute and late post-stroke seizures are stroke severity and cortical location. Most seizures following stroke are focal at onset, but secondary generalization is common, particularly in patients with late-onset seizures. Status epilepticus is relatively uncommon. The efficacy of antiepileptic drugs for these post-stroke seizures has not been rigorously assessed in controlled trials, although most seizures can be controlled with a single agent. Given the relatively low frequency of recurrent seizures after stroke, and an absence of absolute predictors of poststroke epilepsy, the decision of when to treat patients for a post-stroke seizure is difficult.

Epilepsy seizure types, classification and treatment

Epilepsy is a chronic condition whose building blocks are recurrent seizures. It is this varied presentation that at times poses a challenge to making a diagnosis. The response to treatment is also not uniform, making it necessary to individualise. This article discusses the various seizure types, the latest classification by the International League against Epilepsy (ILAE), treatment and prognosis of the condition

Evaluación comparativa entre los perfiles de disolución de comprimidos similares de lamotrigina de 25mg y el fármaco innovador, comercializados en Paraguay / Evaluation comparative between dissolution profiles of tablets 25mg lamotrigine similar and innovative drug, traded in Paraguay

La epilepsia es la enfermedad neurológica más frecuente en el mundo, esta situación impulsó el desarrollo de nuevos fármacos anticonvulsivantes (FAE) como lamotrigina (LMT) que presenta un elevado costo económico para la población con crisis convulsivas. El propósito del estudio fue comparar los perfiles de disolución de comprimidos de LMT de 25 mg (Test) comercializados en Paraguay y la Referencia (Lamictal®). Se tomaron productos de LMT 25mg comprimidos, con registros sanitarios vigentes y comercializados en Paraguay, realizándose los controles de calidad acorde a criterios generales de las farmacopeas oficiales. Posteriormente, se determinó la cinética de disolución de los productos Test y Referencia, en los 3 medios de disolución recomendados (pHs 1,2 ; 4,5 y 6,8). Los perfiles de disolución de los productos evaluados de LMT, presentaron comportamientos similares a los diferentes pHs, liberando más del 85% a los 15 minutos en los 3 medios de disolución, no siendo necesario la comparación con la prueba f1 y f2. Se concluye que la cinética de disolución de los comprimidos de LMT de 25mg analizados, mostraron un comportamiento in vitro semejante entre las formulaciones. Estos resultados son orientadores, permitiendo tan sólo guiar prospectivamente la puesta en marcha del ensayo de bioequivalencia entre el medicamento Test y Referencia evaluado in vitro. Se pretende que estos ensayos llevadosa cabo con LMT, constituyan el paso inicial, para estudiar el comportamiento de las cinéticas de disolución de otros medicamentos Test y sus correspondientes Referencias del mercado paraguayo.

Epilepsy is the most common neurologic disease in the world, this situation boosts the development of new anticonvulsant drugs (AEDs) as lamotrigine (LMT) having, the latter, ahigh economic cost for the population with seizures. The aim of the study was to comparethe dissolution profiles of LMT tablets of 25 mg (Test) marketed in Paraguay and the Reference or innovator (Lamictal®). LMT 25mg tablets were chosen with the current health register sold in Paraguay and performing the quality controls according to general criteria ofthe official pharmacopoeia. Subsequently, the kinetics of dissolution of the Test and Reference products were determined in the three recommended dissolution media (pH 1,2 ; 4,5 and 6,8). The dissolution profiles of LMT products evaluated presented similar behaviorat the three different pHs, releasing more than 85% within 15 minutes in the three dissolution media. No comparison with the f1 and f2 test was necessary. The kinetics of dissolution of the tablets of LMT 25 mg analyzed showed a similar in vitro behavior between the formulations. These results constitute only a guide for the implementation of bioequivalence studies between the Test and the Reference assayed in vitro. These tests carried out with LMT could emerge as an initial step in order to study the behavior of dissolution profiles of the Test product and the corresponding references in the Paraguayan market.

Guías de buenas prácticas para la atención psicológica y social al paciente con epilepsia / Good practice guidelines for the social and psychological care to the patient with epilepsy

En la actualidad cobra vital importancia la preparación y divulgación de guías o protocolos de intervenciones esenciales para la atención del paciente epiléptico en el primer nivel de atención, ya que con frecuencia estos pacientes son victimas de imprecisiones terapéuticas. El propósito de este trabajo es presentar guías de buenas prácticas para la atención psicológica y social de este paciente. Se realizó análisis de contenido de los reportes de investigaciones que sobre atención psicosocial al paciente con epilepsia se prepararon en Cuba entre 2004 y 2013. A partir de la evidencia valorada se elaboraron las guías de buenas prácticas para la atención psicológica y social del paciente con epilepsia y en ellas se precisó la estructura asistencial y los recursos materiales necesarios, se describieron los procederes de actuación en orden cronológico: entrevistas clínico-psicológico y técnicas de evaluación psicológicas idóneas. Además se precisaron las especificidades para la atención clínico-psicológico al paciente con inadaptación psicosocial a la epilepsia y para la atención clínico-psicológica del paciente con epilepsia y trastornos emocionales asociados. Las guías aportan herramientas de trabajo para evitar la inadaptación psicosocial, los trastornos emocionales y la incapacidad para el autocuidado en pacientes con epilepsia(AU)

The preparation and dissemination of essential intervention guidelines or protocols for the care of patient with epilepsy at the first health care level is gaining importance, since these patients are frequent victims of therapeutic inaccuracies. The objective of this paper was to present good practice guidelines for the psychological and social care of this patient. A content analysis of the reports from research on this topic was made, which were made in Cuba from 2004 to 2013. On the basis of the assessed evidence, good practice guidelines were prepared for the social and psychological care of the patient with epilepsy. They detailed the assistance structure and the necessary material resources for adequate psychological and social care of this patient as well as the procedures of performance in a chronological order: clinical and psychological interview and ideal psychological evaluation techniques. Additionally, the specificities for the clinical and psychological care of the patient with faulty psychosocial adaptation to epilepsy and for the patient with epilepsy and associated emotional disorders were also specified. The guidelines provide working tools to avoid faulty psychosocial adaptation, emotional disorders and inability to self-care in epileptic patients(AU)

Tratamiento con medicamentos antiepilépticos en el niño / Antiepileptic drug treatment for children

El objetivo de este trabajo es realizar una revisión de la literatura sobre el tratamiento con medicamentos antiepilépticos en el niño. Un aspecto importante en el tratamiento de la epilepsia es disminuir o lograr la cesación de las crisis epilépticas para garantizar una calidad de vida adecuada. Existen varios factores que se deben considerar en el momento de seleccionar el primer medicamento antiepiléptico, entre los se encuentran la eficacia relativa, la tolerabilidad, las interacciones medicamentosas y seguridad a largo plazo del fármaco seleccionado, el tipo de crisis epiléptica, el síndrome epiléptico, la edad, el sexo, el peso, las comorbilidades asociadas, entre otros. Si se decide emplear tratamiento adjunto, deben combinarse medicamentos con diferentes mecanismos de acción. Todos los antiepilépticos clásicos o de primera generación son medicamentos eficaces que continúan desempeñando un papel importante en el tratamiento actual de la epilepsia. Estos fármacos en la actualidad se emplean en el tratamiento de primera opción para muchos tipos de crisis epilépticas o síndromes epilépticos. Son pocos los medicamentos antiepilépticos de segunda generación que en la actualidad se consideran de primera elección para el tratamiento de la epilepsia en el niño

The objective of this paper was to make a literature review on the antiepileptic drug treatment for children. An important aspect of this type of treatment is to reduce or to cease epileptic crises in order to assure better quality of life. There are several factors that should be considered at the time of selecting the first antiepileptic drug such as relative efficacy, tolerability, drug interactions and long-term safety of the selected drug, type of seizure, epileptic syndrome, age, sex, weight, associated comorbidities and others. If one decides to use a combined treatment, then drugs having various mechanisms of action must be selected. The first-generation or classical antiepileptic drugs are all effective and continue playing an important role in the present treatment of epilepsy. These drugs are currently used as treatment of choice for many types of seizures or epileptic syndromes. Few second generation antiepileptic drugs are considered at present to be the first choice for the treatment of epilepsy in the child

Environmental air pollution is an aggravating event for sudden unexpected death in epilepsy / Exposicao ambiental a poluicao do ar e um evento agravante para a ocorrencia de morte subita nas epilepsias

It is extremely difficult to estimate the occurrence of sudden unexpected death in epilepsy (SUDEP). On the other hand, discovering and carefully evaluating new risk factors that may contribute to the onset of cardiovascular abnormalities in people with refractory epilepsy may prevent fatal events in these individuals. In this context, we should not ignore that urban air pollution is a leading problem for environmental health and is able to cause serious cardiovascular dysfunctions that culminate in sudden death. In this regard, we aimed to determine whether environmental exposure to air pollution is an aggravating event for SUDEP.

É extremamente difícil estimar a ocorrência de morte súbita em epilepsia (SUDEP). Por outro lado, detectar e avaliar cuidadosamente novos factores de risco que podem contribuir para o aparecimento de alterações cardiovasculares em pessoas com epilepsia refratária poderá ser capaz de impedir a ocorrência de eventos fatais nestes indivíduos. Neste contexto, não devemos negligenciar hoje que a poluição do ar nas grandes cidades é um problema para a saúde ambiental, podendo causar graves disfunções cardiovasculares, que culminam em morte súbita. Neste sentido, propusemos nesse trabalho que a exposição ambiental a poluição do ar é um evento agravante para a ocorrência de SUDEP.

Primera convulsión febril en niños asistidos en un servicio de emergencia pediátrica / First febrile seizure in children seen in pediatric emergency service

Introducción: las convulsiones febriles (CF) son un motivo frecuente de consulta en los servicios de emergencia. Frecuentemente estos niños son hospitalizados, se les realiza diversos estudios complementarios y pueden motivar interconsultas con especialistas. A pesar de su carácter benigno, provocan gran ansiedad familiar.Objetivo: describir las características clínicas, los estudios paraclínicos y la evolución de los pacientes que consultaron en el servicio de emergencia del Hospital Británico entre el 1º de enero de 2001 al 31 de diciembre de 2008 con una primera CF.Material y método: se realizó un estudio descriptivo, de tipo cohorte histórica a partir de la revisión de las historias clínicas. Se describieron las características clínicas de los pacientes al ingreso y en la evolución se valoró recurrencia de la crisis en el mismo o en otro episodio febril, tratamiento antiepiléptico a largo plazo y crisis en apirexia posteriores a la primera CF. Resultados: se incluyeron 113 niños, media de edad 23 meses. En 84% la etiología de la fiebre fue una infección respiratoria alta. Se realizó relevo infeccioso en 78% de los niños, relevo metabólico en 15% y punción lumbar en 8%.Las convulsiones se reiteraron en 25% de los pacientes. Se realizó electroencefalograma en 53% de los pacientes,estudios de neuroimagen a cuatro pacientes e interconsulta con neuropediatra en 21. El 7% de los pacientes recibieron anticonvulsivantes en la primera crisis. Presentaron crisis enapirexia posteriores a la CF 4% de los pacientes.Conclusiones: en términos generales, los resultados coinciden con los datos reportados por los estudios realizados en otros países.

The promise of omega-3 against sudden unexpected death in epilepsy: until further notice, it remains innocent, until proven guilty / Promessa do ômega-3 contra a morte súbita em epilepsia: até segunda ordem, continua inocente, até que se prove o contrário

The present paper highlighted the importance of the recommended levels of fish consumption or omega-3 supplementation in order to minimize the frequency of seizures in people with uncontrolled epilepsy and, especially, to reduce the occurrence of sudden unexpected death in epilepsy (SUDEP).

O presente trabalho destacou a importância dos níveis recomendados de consumo de peixe ou suplementação de ômega-3 com o intuito de minimizar a frequência de crises epilépticas em pessoas com epilepsia refratária e, especialmente, de reduzir a ocorrência de morte súbita inesperada em epilepsia (SUDEP).

Cuidado integral de personas con epilepsia PROEPI

La epilepsia es una de las enfermedades neurológicas másfrecuentes y se origina por una descarga hipersincrónica deun grupo de neuronas a nivel de la corteza cerebral.Se expresa a través de cambios súbitos de la conducta hastacrisis convulsivas generalizadas, cuyas manifestacionesclínicas van a depender del sitio de origen de la epilepsia yde la forma de propagación que adopte la descarga. Afectaalrededor del 0,5% de toda la población (1 cada 200habitantes) y la epilepsia activa entre 4 y 8 casos por 1000habitantes. En nuestro país hay aproximadamente 200.000enfermos con diagnóstico de epilepsia, y estimamos que enla provincia de Buenos Aires hay aproximadamente 78.000pacientes.Se trata de una patología que puede presentarse desde elnacimiento, con una tendencia que se expresa a través deuna curva bimodal con predominio en la primera década devida y reaparición luego de los 60 años. La etiología esdiversa: causa genética, estructural o metabólica y de causadesconocida. En el grupo estructural las causas másfrecuentes prevenibles son las enfermedades infecciosas(neurocisticercosis, meningoencefalitis), el daño cerebralperinatal, las enfermedades vasculares y el traumatismo decráneo.La enfermedad es controlable en cerca del 70% de los casoscon drogas antiepilépticas (DAEs). El 30% de los enfermosno responden a los diferentes medicamentosanticomiciales, comportándose como refractarios a lamedicación. En estos casos, la cirugía es una alternativa,permitiendo hasta un 80% de probabilidad de control decrisis discapacitantes. Aproximadamente 20.000 pacientescon epilepsia se encuentran asistidos por el ProgramaPROEPI, recibiendo insumos para control y tratamientodiario de su enfermedad.

Interchangeability among therapeutic equivalents of lamotrigine: evaluation of quality of life

Epilepsy is the most common serious neurological disorder worldwide. Approximately 70% of patients with epilepsy have their seizures controlled by clinical and pharmacological treatment. This research evaluated the possible influence of interchangeability among therapeutic equivalents of LTG on the clinical condition and quality of life of refractory epileptic patients. The study was divided into three periods of 42 days, and an equivalent therapeutic LTG randomly dispensed for each period (two similars - formulations A and B, and the reference product - formulation C). The mean dose of LTG was 5.5 mg/kg/day. The presence of side effects tends to have a greater deleterious effect on quality of life of refractory epileptics compared to variations in number of seizures or changes in plasma concentrations. The results showed that independently of the drug prescribed, interchangeability among therapeutic equivalents can negatively impact epilepsy control.

Epilepsia é o distúrbio neurológico grave mais comum no mundo todo. Aproximadamente 70% dos pacientes com epilepsia têm suas crises controladas com tratamento clínico e farmacológico. Esta pesquisa avaliou a possível interferência da intercambialidade entre equivalentes terapêuticos da lamotrigina na condição clínica e na qualidade de vida dos pacientes com epilepsia refratária. O estudo foi dividido em três períodos de 42 dias e em cada período foi dispensado um equivalente terapêutico, aleatoriamente (dois similares - formulação A e B e o medicamento de referência - formulação C). A dose média de lamotrigina foi de 5,5 mg/kg/dia. A ocorrência de efeitos colaterais tende a ser mais decisiva para a redução da qualidade de vida em epilepsia refratária em relação às variações no número de crises ou alterações nas concentrações plasmáticas. Os resultados demonstram que, independentemente do medicamento prescrito, a intercambialidade entre equivalentes terapêuticos pode interferir no sucesso do controle da epilepsia.

anticonvulsant and neuroprotective effects of walnuts on the neurons of rat brain cortex

Epilepsy is a chief communal health problem. Antiepileptic drugs only provide symptomatic treatment. Walnut Kernels [WK] have high concentrations of phenolic compounds, which have beneficial effects on human health because of their antioxidant and anti-atherogenic properties. The present study was designed to evaluate the efficacy of WK supplementation for the prevention of experimental epilepsy in male rats. Wistar adult male rats were divided into three groups: a control group [PTZ injection, fed with ordinary food], experimental group [PTZ injection, fed with WK] and a sham group [no PTZ injection, only for histological studies]. Pentylenetetrazole [PTZ] was administered after the prescribed time. WKs displayed anti-epileptogenic properties, and WK supplementation was associated with increased seizure threshold and reduced mortality in the experimental group versus controls. Use of WK may be helpful in prevention of PTZ-induced seizure and its further neurodegeneration in male rats

The utility of omega-3 fatty acids in epilepsy: more than just a farmed tilapia! / A utilidade do ácido graxo ômega-3 na epilepsia: mais do que uma criação de tilápias!

The epilepsies are one of the most common serious brain disorders and 20 to 30 percent of people developing epilepsy continue to have seizures and are refractory to treatment with the currently available therapies. Approximately one in a 1000 patients with chronic epilepsy will die suddenly, unexpectedly, and without explanation, even with post-mortem examination and this phenomenon is called sudden unexplained death in epilepsy (SUDEP). Understanding the mechanisms underlying SUDEP may lead to the identification of previously unrecognized risk factors that are more amenable to correction. We discuss here the possible implications of omega-3 fatty acids consumption on SUDEP prevention.

As epilepsias encontram-se entre as mais sérias doenças neurológicas; 20 a 30 por cento dos pacientes com epilepsia continuam apresentando crises e são refratários as terapias disponíveis atualmente. Aproximadamente um em cada 1000 pacientes com epilepsia crônica irá morrer de forma súbita, não esperada e sem explicação, mesmo com o exame pós-morte. Este fenômeno é denominado morte súbita e inesperada em epilepsia (SUDEP). Compreender os mecanismos envolvidos nos casos de SUDEP pode levar à identificação de fatores ainda não reconhecidos e passíveis de serem corrigidos. Discutiremos a seguir as possíveis implicações do consumo do ácido graxo ômega-3 na prevenção dos casos de SUDEP.

Advanced understanding in mechanisms of epilepsy and potential new treatment strategies

Over the last 25 years, neurobiologists have begun to unravel the cellular mechanisms that underlie epileptiform activity. Such investigations have two main objectives: [1] to develop new methods for treating, [curing], or preventing epilepsy; and [2] to learn more about the normal functioning of the human brain, at the cellular/molecular and neurological/psychological levels by analyzing abnormal brain functioning. The electroencephalogram [EF.G] spike is a marker for the hyperexcitable cortex and arises in or near an area with a high epileptogenic potential. The depolarizing shift [DS] that underlies the interictal discharge [ID] appears to be generated by a combination of excitatory synaptic currents and intrinsic voltage-dependent membrane currents. The hyperpolarization that follows the DS [post-DS-1 IT] hunts ID duration, determines ID frequency, and prevents ID deterioration into seizures. The disappearance of the post-DS I IP in some models is related to the onset of seizures and the spread of epileptiform activity. During the transition to seizures, the usually self-limited ID spreads in time and anatomical space. Several processes may intervene in the pathophysiolpgical dysfunction. These include enhancing GABA-mediated inhibition, dampening NMDA-mediated excitability, interfering with specific Ca[2+] currents in central neurons, and perhaps stimulating [gating] pathways

IBE Promising Strategies Program 2008: "Epilepsy at School: Teaching the Teachers" - educational plan of the "Associação Brasileira de Epilepsia" with teachers of elementary school / Programa IBE Promising Strategies 2008: "Epilepsia nas Escolas: Ensinando os Professores" - plano educacional da Associação Brasileira de Epilepsia com professores de educação básica

INTRODUCTION: The aim of this study is to evaluate trough questionnaires the knowledge about epilepsy of Elementary School teachers obtained in the "Promising Strategies Program 2008" from International Bureau for Epilepsy entitled "Epilepsy at School. Teaching the Teachers." performed by the official Brazilian branch "Associação Brasileira de Epilepsia" (ABE). METHODS: A questionnaire was developed by ABE and it is composed by 35 objective questions concerning the following areas: concepts and definition of epilepsy and its causes (10); treatment and adverse effects of antiepileptic medication (10); popular stigma about epilepsy (5); activities of people with epilepsy (PWE) (5); and finally, first-aid during and after an epileptic seizure (5). The questionnaire was presented in phase (ph) 1 to teachers before the lecture "Epilepsy: Causes, symptoms and treatment" given by a health professional from ABE trough classical live class (CC) or by video-conference (VC) on "Rede do Saber's site" (http://www.rededosaber.sp.gov.br/portais/NotíciasConteúdo/tabid/369/language/pt-BR/IDNoticia/851/Default.aspx) and afterwards in ph 2. The results were compared to a control group of 66 teachers that did not attend any lecture. RESULTS: Classical class was given in four different cities of Brazil and VC was performed in the state of Sao Paulo and was transmitted to 74 different cities, including Sao Paulo city, this latter with 12 sites; 1,153 teachers were instructed either by CC 25 percent (288) or VC 75 percent (865). Most (78.5 percent) were female, aged between 18 to 68 years (mean 41.4); 76.6 percent attended University and 21.1 percent, graduate studies; 50 percent affirmed to know a PWE. The mean of right answers in ph 1 in CC was 78.4 percent (±10.1) and VC, 79.8 percent (±8.6) and in ph 2 in CC, 86.5 percent (±6.4) and VC, 86.8 percent (±7.1), reflecting increased knowledge in ph 2 (p<0.001) in the 2 strategies (control group: ph 1, 78.2 percent±7.4; ph 2, 79.6 percent±8.6; p>0.05). Comparison of variability of the combined action (CC+VC) between ph 1 (79.5 percent±8.6) and 2 (86.8 percent±6.8) was 9.9 percent±13.9 (p<0.001) (control group 2.3 percent±10.2; p<0.001, compared to CC+VC). The topics "popular stigma" and "first aid during seizures" had the lowest correct scores in ph 1 (CC+VC), 74.6 percent and 72.8 percent, respectively (control group 78.8±10.2 and 67.9±17.5). The highest gain (35.6 percent) in ph 2 was observed in "first aid" (control group 0.8±27.2, p<0.001) and the lowest (0.1 percent), in "popular stigma" (control group 1.7±26.4, p>0.05). There was a significant variation in the topic "first aid" in CC, 41.1 percent compared to VC, 33.3 percent (p=0.009). CONCLUSION: The educational plan of the "Associação Brasileira de Epilepsia" revealed good performance of the teachers of Elementary School without significant differences between the types of presentation (CC/VC), although CC was more efficient to teach first aid during epileptic seizures. The topic "Popular stigma about epilepsy knowledge" has not improved after the lectures and this subject still needs further research and efforts for better understanding and action planning.

OBJETIVOS: Avaliar através de questionários o conhecimento obtido pela ação educativa com professores de Educação Básica intitulada "Epilepsia nas Escolas: Ensinando os Professores" no programa "Promising Strategies 2008" do International Bureau for Epilepsy realizado pelo capítulo oficial brasileiro, a Associação Brasileira de Epilepsia (ABE). MÉTODOS: Questionário foi desenvolvido pela ABE com 35 questões objetivas abrangendo os tópicos: conceitos e definições da epilepsia (10); tratamento e reações adversas de medicações antiepilépticas (10); atividades físicas e profissionais da pessoa com epilepsia (PCE) (5); conhecimento popular estigmatizante (5); cuidados básicos durante e após a crise (5). O questionário foi aplicado antes (Fase 1) e depois (Fase 2) da palestra "Epilepsia: Causas, Sintomas e Conduta" por aula presencial (AP) e videoconferência (VC) na "Rede do Saber" (http://www.rededosaber.sp.gov.br/portais/NotíciasConteúdo/tabid/369/language/pt-BR/IDNoticia/851/Default.aspx). Os resultados foram comparados a um grupo controle de 66 professores que não assistiram à aula sobre epilepsia. RESULTADOS: Aula presencial foi ministrada em quatro cidades brasileiras e VC foi transmitida a 74 cidades do estado de São Paulo, incluindo a capital, esta última com 12 sítios de transmissão. Foram instruídos 1.153 educadores por AP 25 por cento (288) e VC 75 por cento (865). A maioria (78,5 por cento) era do sexo feminino, com idades de 18 a 68 anos (média 41,4); 76,6 por cento cursaram ensino superior e 21,1 por cento, pós-graduação; 50 por cento afirmou conhecer PCE. A média de acertos na fase 1 em AP foi de 78,4 por cento (±10,1) e VC, 79,8 por cento (±8,6) e na fase 2 em AP 86,5 por cento (±6,4) e VC, 86,8 por cento (±7,1), refletindo aumento do conhecimento na fase 2 (p<0,001) nas 2 estratégias (grupo controle: fase 1, 78,2 por cento±7.4; fase 2, 79,6 por cento±8.6; p>0,05). A comparação da variação da ação conjunta (AP+VC) entre fase 1 (79,5 por cento,±8,6) e 2 (86,8 por cento,±6,8) foi de 9,9 por cento±13,9 (p<0,001) (grupo controle 2.3 por cento±10.2; p<0,001, comparado a CC+VC). Os tópicos "conhecimento estigmatizante" e "cuidados básicos" tiveram menor índice de acerto na fase 1 (AP+VC), 74,6 por cento e 72,8 por cento, respectivamente (grupo controle 78,8±10,2 e 67,9±17,5). No entanto, o maior ganho (35,6 por cento) na fase 2 se deu em "cuidados básicos" (grupo controle 0,8±27,2, p<0,001) e o menor (0,1 por cento), em "conhecimento estigmatizante" (grupo controle 1,7±26,4, p>0,05). Houve significante variação do tópico "cuidados básicos" em AP 41,1 por cento comparada à VC 33,3 por cento (p=0,009). CONCLUSÃO: A ação educativa da ABE mostrou bom aproveitamento dos educadores sem diferenças significativas entre os modos de divulgação (AP/VC), porém AP foi mais eficiente em ensinar cuidados básicos na crise epiléptica. O tópico "Conhecimento Popular Estigmatizante sobre Epilepsia" não mostrou aumento após a aula, sendo necessários esforços conjuntos em pesquisa e planejamento estratégico nessa área.

IV Escola Latino-Americana de Verão em Epilepsia: chamada especial aos epileptologistas brasileiros / IV Latin-American Summer School on Epilepsy: special call to the brazilian epileptologists

INTRODUÇÃO: Produzir tratamentos novos e efetivos aliados à prevenção adequada das epilepsias, a doença neurológica crônica grave mais comum e que acomete aproximadamente 1 por cento da população mundial, deve ser o principal objetivo dos sistemas de saúde de uma nação. OBJETIVOS: Nesse sentido, o principal objetivo de nosso artigo é divulgar a IV Escola Latino-Americana de Verão em Epilepsia entre os epileptologistas brasileiros.

INTRODUCTION: The development of new treatments and effective means to prevent the epilepsies, the most prevalent neurological disorder and that affects around 1 percent of worldwide population, must be the main goal of the health systems of a nation. OBJETIVES: Following these reasoning, the goal of our article is to promote the IV Latin-American Summer School on Epilepsy (LASSE) among Brazilian epileptologists.