Clinical spectrum and neuroimaging findings in children with seizures: A five-year retrospective study

Seizures are the most common neurological illness in the pediatric population and account for 1% of all emergency department (ED) visits and 2% of all visits to children's hospital EDs. Pediatric epilepsy presents with various diagnostic challenges. Neuroimaging, especially structural neuroimaging and preferably MRI brain, plays an essential role in diagnosing, managing, and guiding pediatric epilepsy treatment.The study aimed to estimate the clinical spectrum of seizures in children and examine the neuroimaging findings in children with seizures.

The study was a hospital-based retrospective observational study. The hospital case records of all children belonging to the age group 1 month to 12 years with 'seizures' were reviewed for 5 years from Jan 2016 to Dec 2020. Clinicodemographic profiles and neuroimaging (CT/MRI) findings were obtained, and descriptive statistics were applied.

A total of 838(11%) children in the age group 1 to 144 months (mean±SD: 32.57±32.65) presented with seizures, of whom 515(61.5%) were boys and 323(38.5%) girls. Of 596(71.1%) children under five years, 409(68.6%) had febrile seizures. Generalized onset-motor seizures were the predominant type of seizures seen in 666(79.4%) children, of whom 434(65.1%) had febrile seizures.Neuroimaging (CT/MRI) was normal in 335(40%) and abnormal in 124(14.8%) children. Perinatal insult (7%) was the most common abnormality, followed by CNS infections (2.8%).

Neuroimaging, preferably MRI brain, is the most helpful tool for the etiological diagnosis of afebrile seizures.In our study, seizures secondary to perinatal insult/hypoxic insult followed by infections were major causes. Improvement in peripartum and perinatal care coupled with a targeted Tuberculosis control program may help in reducing these potentially preventable causes.