{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T12:53:38Z","timestamp":1740142418011,"version":"3.37.3"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"08","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background\u2003Epilepsy is a common neurological disease that affects people all over the world, but it is rarely described in indigenous peoples.<\/jats:p><jats:p>Objective\u2003To study the epilepsy characteristics and risk factors for seizure control in people from an isolated indigenous population.<\/jats:p><jats:p>Methods\u2003This is a retrospective and historical cohort study conducted from 2003 to 2018 (15 years), at a neurology outpatient clinic, of 25 Waiwai tribes' indigenous individuals with epilepsy, inhabitants of an isolated forest reserve in the Amazon. Clinical aspects, background, comorbidities, exams, treatment, and response were studied. Factors that impacted seizure control over 24 months were identified using Kaplan-Meier curves and Cox and Weibull regression models.<\/jats:p><jats:p>Results\u2003The majority of cases started in childhood, with no difference regarding gender. Focal epilepsies were predominant. Most patients had tonic-clonic seizures. A quarter of them had a family history, and 20% had referred febrile seizures. There was intellectual disability in 20% of patients. Neurological examination and psychomotor development were altered in one third of the participants. The treatment controlled 72% of the patients (monotherapy in 64%). Phenobarbital was the most prescribed anti-seizure medication, followed by carbamazepine and valproate. The most relevant factors that impacted seizure control over time were abnormal neurological exam and family history.<\/jats:p><jats:p>Conclusion\u2003Family history and abnormal neurological exam were predicted risk factors for refractory epilepsy. Even in an isolated indigenous tribe, the partnership between the indigenous people and the multidisciplinary team ensured treatment adherence. The public healthcare system must guarantee modern anti-seizure medications, mainly for this vulnerable population, which has no other source of treatment.<\/jats:p>","DOI":"10.1055\/s-0043-1769125","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T22:56:30Z","timestamp":1688511390000},"page":"725-733","source":"Crossref","is-referenced-by-count":1,"title":["The challenges to control epilepsy in an isolated indigenous tribe in Brazil's Amazon: 15 years of follow-up"],"prefix":"10.1055","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9700-9938","authenticated-orcid":false,"given":"Marcos Manoel","family":"Honorato","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."},{"name":"Universidade do Estado do Par\u00e1, Centro de Ci\u00eancias Biol\u00f3gicas e da Sa\u00fade, Departamento de Sa\u00fade Integrada, Santar\u00e9m PR, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8205-4816","authenticated-orcid":false,"given":"Renata Carvalho","family":"Cremaschi","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8482-3754","authenticated-orcid":false,"given":"Fernando Morgadinho Santos","family":"Coelho","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."},{"name":"Universidade Federal de S\u00e3o Paulo, Escola Paulista de Medicina, Departamento de Psicobiologia, S\u00e3o Paulo SP, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1111\/j.1528-1167.2011.03099.x","article-title":"Understanding the differences in prevalence of epilepsy in tropical regions","volume":"52","author":"L P Yemadje","year":"2011","journal-title":"Epilepsia"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"301","DOI":"10.3389\/fneur.2017.00301","article-title":"Drug-Resistant Epilepsy: Multiple Hypotheses, Few Answers","volume":"8","author":"F Tang","year":"2017","journal-title":"Front Neurol"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1159\/000503831","article-title":"The epidemiology of epilepsy","volume":"54","author":"E Beghi","year":"2020","journal-title":"Neuroepidemiology"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s40249-017-0245-y","article-title":"The causal relationship between neurocysticercosis infection and the development of epilepsy - 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