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Clinico-etiological Profile and Developmental Status of Infants Aged 1-24 months with Epilepsy
Pankaj Kumar Sahu1, Devendra Mishra1, Monica Juneja1
1Department of Pediatrics, Lok Nayak Hospital and Maulana Azad Medical College (University of Delhi), 2, Bahadur Shah Zafar Marg, New Delhi, 110 002, India.
Insights
Pediatric epilepsy in infants under two years is often symptomatic, with birth asphyxia being a leading cause. Early evaluation and intervention are crucial due to high rates of developmental delay in these children.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Epileptology
Background:
- Epilepsy is a common neurological disorder in infants.
- Understanding the clinico-etiological profile of early-onset epilepsy is crucial for effective management.
- Infantile epilepsy presents unique diagnostic and therapeutic challenges.
Purpose of the Study:
- To investigate the clinical characteristics and causes of epilepsy in infants aged 1-24 months.
- To identify common etiologies and comorbidities in this age group.
- To assess the relationship between neurological findings, neuroimaging, and developmental outcomes.
Main Methods:
- A prospective study enrolled 60 infants (1-24 months) with epilepsy.
- Data collected included detailed history, neurological examination, and developmental assessment using the Developmental Assessment Scale for Indian Infants (DASII).
- Electroencephalography (EEG) and neuroimaging (CT/MRI) were performed on all participants.
Main Results:
- Perinatal asphyxia (45%) and malformations of cortical development (18.3%) were the most frequent causes of epilepsy.
- Abnormal neurological examination (68.3%) and neuroimaging (76%) were common.
- Developmental delay was highly prevalent (81.7%), with profound delay in 28.3% of cases.
Conclusions:
- The majority of epilepsy cases in children under two years are symptomatic, with birth asphyxia as a primary etiology.
- High rates of co-morbid developmental delay necessitate routine evaluation and prompt intervention in high-risk infants.
- Early diagnosis and management are vital for improving outcomes in infantile epilepsy.
Objective:
To study the clinico-etiological profile of epilepsy in children aged 1-24 mo attending a tertiary-care public hospital.
Methods:
All infants aged 1-24 mo with epilepsy (as per International League Against Epilepsy, 2014) presenting between April 2016 and March 2017 were enrolled. Detailed history and examination were done in all children, and developmental assessment was done using Developmental Assessment Scale for Indian Infants (DASII). Electroencephalography and neuroimaging (CT/MRI) were done for all subjects.
Results:
Sixty children (39 males) were consecutively enrolled after informed written consent. The mean (SD) age at seizure onset was 4.3 (4.14) mo. Perinatal asphyxia (45%) and malformations of cortical development (18.3%) were the commonest etiologies. Neurological examination was abnormal in 68.3%, and a neuroimaging abnormality was present in 76% of children. Fifteen patients (25%) had West syndrome, which was symptomatic in the majority (73.3%). Developmental delay (DQ < 70) was the commonest co-morbidity (81.7%); 28.3% had profound delay. Odds of having developmental delay were 13-times higher in those with an abnormal neurological examination [OR 13.5 (2.82-64.67), P = 0.001], and nearly 9-times higher with abnormal neuroimaging [OR 8.9 (2.11-37.9), P = 0.003].
Conclusions:
Epilepsy in children <2 y is symptomatic in the majority, with sequelae of birth asphyxia as the commonest etiology. High prevalence of co-morbid developmental delay underscores the need for routine evaluation and early intervention in all high-risk infants.
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