Clinical and etiological evaluation of secondary seizures by computed tomography and electroencephalogram

Abstract

This study was conducted to determine the clinical evaluation and various etiological factors of secondary seizures in patients admitted to Government Medical College, Nagpur. We evaluated 58 patients of secondary seizures from Dec 2011 to Oct 2013. Secondary seizures were defined as case of seizure with CT (brain) or MRI (brain) abnormality1. Out of 58 cases 35 were males and 23 were females. Mean age of study subjects was 34.85. The commonest presenting feature was generalized tonic clonic convulsions (42 patients) followed by focal seizures (16 patients). Todd’s palsy was observed in 4 cases. Aura was present in 24 cases. According to CT brain scan the aetiology was – neurocysticercosis (34.48%), post stroke (27.59%), tuberculoma (24.14%). Space occupying lesions(SOLs) were present in 8 patients, out of whom 4 had brain tumour, 2 patients had brain abscess, 1 had hydatid cyst and 1 had metastasis. Majority of lesions were located in frontal region (58.62%), followed by in parietal region (44.83%), in temporal region (25.86%) and in occipital region (13.79 % patients). In our study neurocysticercosis was found to be the commonest cause of secondary seizures. As in a meta-analysis it was found that cysticidal drugs result in better outcome in patients of neurocysticecosis, we recommend that the patients of secondary seizures should be identified for the aetiology and treated at the earliest2.