Study of clinical radiological and EEG profile of patients presenting with first episode of generalized tonic clonic convulsions to a tertiary care center

Abstract

Generalised Tonic Clonic Convulsions are one of the common presentation to the emergency department. Proper understanding and approach to the same for a practicing doctor and education to the patient and its family helps in avoiding recurrence and the myths associated with it. Not many studies have studied the association of this clinical presentation in relation to neuroimaging and electroencephalography, hence this study.Study was conducted over a period of 2 years where in all patients presenting to the out patient and emergency department with first episode of generalized tonic clonic convulsion were taken into consideration. Necessary investigation were performed especially MRI Brain and EEG, the data was analysed across various variables and corelated.In present study it was noted around 34% of patients had no specific cause, 60% had normal MRI, 40% had abnormal EEG, incidence was higher in males and in patients in age group between 18-45 years. Stroke and alcohol withdrawal were other common causes followed by metabolic abnormalities, cerebral venous thrombosis, posterior reversible encephalopathy syndrome and cns infections.A detailed history regarding semiology has to be collected, even though sometimes it is difficult to obtain the same. In such situations neuroimaging like MRI Brain and Electroencephalography should be performed in every patient presenting with first episode of generalized tonic clonic convulsion. This approach helps in preventing the recurrences and identifying the exact cause and management of the patients.