STUDYING THE RISK FACTORS FOR EPILEPSY IN THE FIRST FIVE YEARS OF LIFE IN CHILDREN

Abstract

Background: Epilepsy is a disorder of the brain defined by any of the following conditions: At least two unprovoked seizures occurring greater than 24 hours apart, one unprovoked seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years and Diagnosis of an epilepsy syndrome (Fisher et al., 2014). Objectives: We aimed to determine the prevalence of the different risk factor for epilepsy in children below five years. Design: A descriptive cross sectional study that was carried out on 200 epileptic children attending Outpatient Clinic of Neurology Unit of Pediatric Department, Al Hussein and Bab Elsheaia University Hospital.      This research was continued until fulfillment of the study from April 2017 to June 2019. Patient and Methods: All the patients were diagnosed as epileptic patients. Inclusion criteria:- • Age: above 4 weeks and below 5 years. • Epileptic patient, with history of 2 or more seizures. Exclusion criteria:- • Age: children are at or above 5year. • Non – epileptic patient. Results: 54% of children began to suffer from epilepsy at less than one year age while 29% began to suffer from epilepsy between 1year to <3 year and 17% began to suffer from epilepsy between 3 years and <5 years with a mean of 22±8.78 months. - Age ranged from 1 to 3 years with a mean of 22±8.78 months. - As regards the residence, we found that children were living in rural areas 55 (55%) and urban areas 45 (45%). - Social standard was low in 50%, medium in 40% and high in 10%. - Pre-term was reported in 27 cases out of 100 cases (27%), while full-term was reported in 63 cases out of 100 cases (63%) and post-term was reported in 10 cases out of 100 cases (10%). - 71% of the cases have generalized seizures, 21% of the cases have partial seizures and 8% of the cases have unclassified seizures.     - family history of epilepsy were the main known reported risk factors of epilepsy (by 24 %) and 20% of the patients had the family history of epilepsy in their first and second-degree relatives , while febrile convulsions was reported in 22% of epileptic children. 21% reported head trauma as a risk factor. Central nervous system (CNS) infection was 8% of the epileptic children. - 66% of the cases are controlled with anti- epileptic drugs, while 34% of the cases are uncontrolled with anti- epileptic drugs. - 8% of mothers during pregnancy had hemorrhage, 6% of them had diseases as D.M. and hypertension while 8% of them were on medications. Conclusion: Epilepsy is a common neurological disorder. Decision makers must take effective steps to limit the causes and risk factors of the problem.      It is important for pre-natal monitoring to be performed in a regular and accurate manner, for birth to take place under appropriate conditions with the help of health personnel and for the baby to be regularly monitored after birth if the child is to be protected from factors that can impair brain development during or after birth.