CLINICAL AND INVESTIGATIVE FEATURES OF SEIZURE IN CHILDREN ADMITTED IN TERTIARY CARE HOSPITAL OF NORTHERN INDIA

Abstract

Introduction: Convulsions are one of the most common paediatric neurological disorders worldwide, with its incidence being highest among children younger than 3 years of age. It is also one of the most frequent causes for visit to the pediatric emergency department and could either be idiopathic or secondary to disease process of brain. Seizures lead to alterat Aims and objectives: ions in the laboratory values and reect changes in different organ systems. This study was done to evaluate the clinical, laboratory, EEG and CT ndings in cases of seizure among children between 1month to15years of age. It was a descriptive study conducted in patients admitt Materials and methods: ed in emergency and indoor of department of paediatrics, Patna Medical College and Hospital, over a period of 2 years from October 2014 to September 2016. Children from 1 month to 15 years of age with seizures were studied to know the proportion of idiopathic or secondary seizures and to evaluate various laboratory, EEG and CT ndings in these cases. During study period, 200 children between ages Results: 1 month to 15 years, with convulsion, were enrolled. Seizures were found to be more common in males (67.5%). Secondary seizures were present in 90% cases and idiopathic epilepsy accounted only for 10%. GTCS was the commonest type of seizure both in idiopathic epilepsy (100%) as well as in secondary seizure group (87.77%). Family history of seizure disorders was present in 13% of cases. Developmental delay was found in 11.5% cases, whereas 88.5% children were developmentally normal. Commonest symptoms associated with secondary seizures were fever (86.11%), altered sensorium (77.22%), and cough (38.89%). Headache, vomiting, ear discharge, rashes were other symptoms. Altered sensorium (69.5%), neck stiffness (33%), cranial nerve involvement (16%) were commonest signs. Hypocalcemia, hyponatremia and hypoglycaemia were found in 4.5%, 1.67% and 1.11% cases respectively, in cases of secondary seizures. CSF analysis was done in all 200 cases and was found to be normal in all cases (100%) of idiopathic epilepsy, whereas it was abnormal in 81% cases of secondary seizures. Abnormal CSF ndings included low CSF glucose (24.69% cases), high CSF proteins (100%) and CSF pleocytosis in 82.71% cases. EEG was also done in all cases, and was found to be abnormal in 85% cases of idiopathic epilepsy, whereas 43.89% cases of secondary seizures had abnormal recordings. Abnormal EEG recordings were abnormal background activity in 60.41%, generalised interictal discharges (IED) in 77.08% and focal IED in 21.87%. Abnormal CT scan ndings were seen in 60(45.8%) cases. Out of these 60 cases, commonest CT scan abnormalities seen were cerebral oedema (45%), cerebral atrophy (20%), and hydrocephalus (16.7%). Other CT ndings were ring enhancing lesions, basal exudates, infarcts etc.