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Category: Volume 07 Issue 11 November 2019
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Title: To study the clinical profile of children presenting with history of focal seizure for the first time in OPD/IPD in the pediatric age group of 1-18 years and To study multi detector CT findings in children with focal seizures

Authors: Dr Amar Thakur, Dr Ajay Vaid, Dr Milap Sharma, Dr Mohit  Bajaj, Dr Swati Mahajan

 DOI: https://dx.doi.org/10.18535/jmscr/v7i11.147

Abstract

Background: Seizure is defined as transient, involuntary alteration of consciousness, behaviour, motor activity, sensation, or autonomic function caused by an excessive rate and hypersynchrony of discharges from a group of cerebral neurons1. Partial or focal seizures have specified area of origin. The behavioural manifestations of focal seizures are related not only to the part of the brain involved but also to the maturation of the nervous system and integrity of the pathway necessary for clinical expression. New onset partial seizures in an otherwise asymptomatic child may be idiopathic or symptomatic. Common causes of focal seizures reported in India and developing countries are perinatal insult, gliomas, cortical dysplasias, infarcts, neurocysticercosis (NCC) and tuberculomas2. This study was done to find out the clinical profile of focal seizures in pediatric age group and various etiologies related to it.

Methods: It was a hospital based non-interventional prospective study done over a period of one year. All the children 37 were enrolled after meeting inclusion criterias. All the findings were recorded in a pre designed proforma and results were analysed by window SSPE software.

Results: In this study, we enrolled 37 patients. The mean ± SD age of presentation was 10.43 years (4.18 yrs) with a range of 3 - 17 years. Male : female ratio was 1.3:1. 6(16.2%) cases presented with simple partial seizures while 28(75.7%) presented with complex partial seizures. Three patients (8.1%) had focal onset with secondary generalization. Twenty two (59.5%) had left sided and 15(40.5%) had right sided seizures. Twenty patients (54.1%) had more than one episode of seizure prior to being enrolled in the study, 17(45.9%) patients had a first presentation of focal seizure. Eight (21.6%) had single episode while 9(24.3%) had more than multiple episodes of seizures at the time of presentation. an underlying focus of seizure was found in 26(70.2%) patients. Granuloma, in the form of a ring enhancing lesion was seen in 17(45.9%) cases while in 3(8.1%) patients, a structural lesion was seen. There was an area of gliosis in 3(8.1%) and vascular insult/infarct in 3(8.1%) patients. CT scan was normal in11(29.7%) patients.

Conclusion

  • Inflammatory granulomas are the most common cause of partial seizures.
  • Neuroimaging is a valuable tool in identifying etiology of focal seizures.

Keywords: Focal, Seizure.

References

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Corresponding Author

Dr Amar Thakur

Junior Resident, Department of Pediatrics, DR RPGMC Tanda