ETIOLOGICAL EVALUATION OF SEIZURE IN CHILDREN ADMITTED IN TERTIARY CARE HOSPITAL OF NORTHERN INDIA

Abstract

Introduction: Convulsions are one of the most common paediatric neurological disorder worldwide. It could either be idiopathic or secondary to disease process of brain. Incidence of convulsion is highest among children younger than 3 yrs. Aims And Objectives: Current study was done to know the proportion of idiopathic epilepsy and secondary seizures. It further aimed to identify various aetiologies of convulsion in children between 1month to15years of age. Materials And Methods: It was a descriptive study conducted in patients admitted 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 various aetiologies and proportion of idiopathic or secondary seizures. Results: During study period, 200 children between ages 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. Infective aetiologies were the commonest cause followed by febrile seizures. Febrile seizures were commonly seen in age group between 1yr - 5yrs (23.75%). Hypocalcemic seizures were mostly seen in the age group of 1month to 1 year (17.5%). Japanese encephalitis virus and dengue virus as a cause of viral meningoencephalitis were found in 10% and 5% respectively. Conclusion: Incidence of idiopathic epilepsy was less common than secondary seizures. GTCS was the commonest seizure type. CNS infection and febrile seizures were common causes of convulsion in this age group. Bacterial infections were the commonest CNS infections. Serum electrolytes, lumbar puncture, neuroimaging, EEG were important tools in reaching diagnosis