Clinico-etiological profile of first episode of seizure and its correlation with electroencephalogram in children aged 2 months to 18 years

Abstract

Background: Seizure is one of the commonest neurological illnesses. About 4-10% of children experience at least one episode in the first 16 years of life. Approximately 30% of children who experience, first afebrile seizure later develop epilepsy. Risk is approximately 20% if neurological examination, electroencephalogram (EEG) and neuroimaging is normal. The objective of the study is to determine the age of onset, etiology of first episode of seizure in children between the age group of 2 months to 18 years and the pattern of EEG changes in the above group of children.Methods: In a prospective single centre observational study at Cheluvamba tertiary care hospital in Mysore, around 80 children who were admitted with first episode of afebrile seizure to our emergency department between October-2020 to July-2021 (10 months) were studied. Seizures defined using international league against epilepsy (ILAE) and EEG was done for all 80 children and their records were analysed.Results: A total of 80 children presenting with first episode of seizure were included in the study. Toddlers represented the major portion of our study with male gender predominance.  Idiopathic seizure was the most common etiology identified (81.2%), followed by meningitis (7.5%). EEG abnormality was seen in 58.7% of the children which was statistically significant (p<0.05). MRI was done in 72.5% of the children, of which abnormality was seen in only 8.6% of the children.Conclusions: Seizure is mainly diagnosed clinically and EEG can be normal in many children. First episode of seizure is common in the age group of 1-3 years. Normal EEG at present may not indicate the non-recurrence in future. Though EEG interpretation is useful, treatment can be started based on clinical diagnosis and has to be individualized.