Göz Dalması Şikayetiyle Başvuran Hastaların Değerlendirilmesi: Tek Merkez Deneyimi

Abstract

Amaç: Bu çalışmanın amacı, göz dalması atakları şikayeti olan çocukların demografik özelliklerini, atak semiyolojisini ve elektroensefalografik özelliklerini analiz ederek epileptik ve epileptik olmayan etiyolojiyi ayıran faktörleri belirlemektir. Gereç ve Yöntemler: 1 Ekim 2022-1 Aralık 2023 arasında göz dalması şikayetiyle başvuran 56 hasta, retrospektif olarak incelendi. Hastaların yaşı, cinsiyeti, komorbiditeleri, dalmanın diğer özellikleri (süre, sıklık, otomatizma ve atak sonrası semptom varlığı), çocuk nöroloji hekimine ulaşma süreleri ve kim tarafından refere edildikleri sorgulandı. Tüm hastalara elektroensefalografi (EEG) uygulandı. Bulgular: Ellialtı hasta epileptik ve epileptik olmayan etiyolojiye göre ikiye ayrıldı. Otuz-üç hastaya (%59) epileptik olmayan göz dalması, 15 hastaya (%26.7) jeneralize epilepsi, 8 hastaya (%14.3) ise fokal epilepsi tanısı konuldu. Epileptik olmayan gruptaki hastaların dalma süresinin ve atak sıklığının daha fazla olduğu, verbal uyarı yanıtının görüldüğü, atak sonrası semptomunun olmadığı saptandı (p<0.001). Dalma şikâyetiyle başvuran hastaların çocuk nöroloji hekimine ulaşma süresi 5.5 gün, hastaların sonuçlandırılma süresi 6.6 gün olarak hesaplandı. EEG epileptik grubun tamamında tanısaldı. Hastaların çoğu pediatrist ve aile hekimleri tarafından yönlendirilmişti (p<0.001). Sonuç: Göz dalması şikayetinin nedenini belirlemek daha sonraki takip için çok önemlidir. Bu çalışmada etyolojinin belirlenmesinde öykü ve rutin EEG’nin önemi vurgulanmıştır. Ülkemizde pediatrik nörologlara erişim ve kesin tanı süresinin literatüre göre daha kısa olduğu görülmüştür. Ayrıca çocuk doktorları ve aile hekimlerinin göz dalması atakları konusunda farkındalıklarının yüksek olduğu söylenebilir.

Keywords

• Çocuk
• epilepsi
• epileptik nöbetler
• göz dalması

Evaluation of Patients Complaining of Staring Spells: Single Center Experience

Abstract

Objective: This study aimed to analyze the demographic characteristics, spell semiology, and electroencephalographic characteristics of children with a complaint of staring spells and determine the factors that differentiate epileptic and non-epileptic etiology. Material and Methods: Fifty-six patients were included retrospectively between October 1, 2022, and December 1, 2023. The patients’ age, gender, co-morbidities, and other characteristics of the staring spells (duration, frequency, automatism, and presence of post-attack symptoms), access time to the pediatric neurologist, referring unit and access time to the final diagnosis were also recorded. Electroencephalography (EEG) was performed on all patients. Results: Fifty-six patients were divided into two according to epileptic and non-epileptic etiology. Thirty-three patients (59%) were diagnosed with non-epileptic staring spells, 15 (26.7%) were diagnosed with generalized epilepsy, and 8 (14.3%) were diagnosed with focal epilepsy. The non-epileptic group had a longer spell time and spell frequency, the presence of verbal stimulation response, and no post-attack symptoms (p<0.001). The access time to the pediatric neurologist was detected as 5.5 days, and the access time to the final diagnosis was 6.6 days. EEG was diagnostic in 100% of the epileptic group. Most of the patients were referred by pediatricians and family physicians (p<0.001). Conclusion: Identifying the cause of staring spells is crucial for further follow-up. In this study, we emphasized that history and routine EEG are important to determine the etiology. It has been observed that access time to pediatric neurologists and final diagnosis are shorter in our country compared to the literature. It can be concluded that pediatricians and family physicians have a high awareness of staring spells.

Keywords

• Childhood
• epilepsy
• staring spells
• epileptic seizure

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