Prevalence and Etiology of Seizures in Kashmir

Abstract

Background: Seizures and epilepsy are common neurological disorders which significantly affect the quality of life. About 10 % of the population experiences a seizure in their lifetime, and are a common source of referrals for neurological consultation. Seizures can vary from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions and vary in frequency, from less than 1 per year to several per day. Owing to scanty information on epidemiology and etiology on seizures in Kashmir, the present study was undertaken to provide update, identify gaps in our present knowledge. Methodology: This was a prospective and observational study undertaken in two phases. In the first phase households in Hazratbal Community Block Srinagar were surveyed for seizure disorder using cluster sampling. Individuals with seizures were clinically evaluated with detailed history and thorough clinical examination as per protocol in the second phase. All patients were subjected to haematological, biochemical and radiological examination. Special investigations like EEG, and CSF analysis were done wherever it was required for patient. Results: The total number of cases included in this study was 47 with male to female ratio of 1:0.88. Majority of the cases were in the age group of 20-39 years followed by 40-59 years. Neuroinfection was the predominant cause of seizures with encephalitis accounting for 12.63%. Other causes included cerebrovascular accidents (25.53%), metabolic (17.02%), miscellaneous (8.51%) and idiopathic (12.76 %).Higher incidence of seizures was observed in the age group of 20-29, followed by 40-49 and 30-39 age groups. Neuroinfection was observed as the leading cause of seizures in the age group of 20- 29 years, followed by age group of 40-49 and 30-39 years. In the age group of 50-59 years metabolic was the common cause of seizures followed by CVA and neuroinfection. Cerebrovascular accidents were found important cause for seizures in all age groups with higher incidence in 40-49 age groups. Conclusion: Prevalence is a measure of the disease burden in the community which has to be considered when planning the health needs. Seizure being a medical emergency, determination of its epidemiology and etiology is a necessary step in its prevention and management. In a sample of 15748 taken randomly out of a population of 150,000, 47 cases of seizure were found. Majority of seizures occurred in the age groups of 20-49 years. Etiological spectrum of seizures was varied and included cerebrovascular accidents, neuroinfection, metabolic, tumour, idiopathic. Neuroinfection and CVA account for significant number of seizures in all age groups.