Study of etiological profile of infantile and childhood focal seizures at a tertiary care centre in South India

Abstract

Objective is to evaluate the etiology of focal seizures at a tertiary care center in Indian children. Design is a cross sectional study. Setting is outpatient and inpatient of a tertiary care teaching children hospital in South India. A total of 150 consecutive children aged 1 mo to 18 yr presenting with focal seizures defined as per international league against epilepsy classification, participated in this study. A detailed history was taken and clinical examination was done was along with the investigation for the etiology of focal seizures with routine and specific tests, computerized tomography (CT) scan and/or magnetic resonance imaging (MRI) and electroencephalography (EEG). All of the findings were recorded in a pre-designed pro forma and results were analyzed. The mean age presentation was 6.5 yr. Male preponderance was noticed with a ratio of 1.2 : 1. Complex partial seizures were the most common (68%) type of focal seizures. Neurologic deficits were noticed in 36 (24%) patients; most common form was hemiparesis. CT scan abnormalities were noted in 76% of the patients, most common CT finding was inflammatory granuloma. In four cases, where CT scan was inconclusive of neurocysticercosis (NCC) versus tu- berculoma, MRI showed features of tuberculoma. The most common etiology of focal seizures was inflammatory granulomas; NCC (69%) and tuberculoma (15%), followed by perinatal insult (8%) and stroke (7.3%). EEG was diagnostic in cases of Rolandic epilepsy in seven (4.6%) cases. CT brain is a valuable tool in identifying the underlying etiology of focal seizures. MRI is helpful in cases of diagnostic dilemma between NCC and tuberculoma by CT scan. EEG is diagnostic of benign Rolandic epilepsy.