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Distinctive Clinico-electrographic and Radiological Profile of Childhood and Adolescent Seizures
Rashmie Prabha1, Rahul Bhakat1, Kriti Mohan2
1Department of Pediatrics, All India Institute of Medical Science, Rishikesh, Uttarakhand, India.
Insights
Electroencephalogram (EEG) and neuroimaging correlate well with seizure semiology in children. Microcephaly and developmental delay are key clinical signs in pediatric seizure disorders.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
- Neuroimaging
Background:
- Electroencephalogram (EEG) is specific but not sensitive for epilepsy diagnosis.
- Accurate diagnosis of childhood seizure disorders requires correlating clinical, electrophysiological, and radiological findings.
Purpose of the Study:
- To correlate clinico-electrographic and radiological features of seizure disorders in children.
- To evaluate the diagnostic utility of EEG and neuroimaging in pediatric epilepsy.
Main Methods:
- Study included 110 children aged 1-18 years with seizure episodes.
- Clinical details, EEG, and neuroimaging (MRI) were evaluated.
- Data were analyzed using appropriate statistical methods.
Main Results:
- The most common seizure type was Generalized Tonic Clonic Seizure (GTCS).
- Hypoxic-ischemic encephalopathy (HIE) sequelae and neurocysticercosis were common etiologies.
- EEG and neuroimaging findings correlated well with seizure history (Cohen's kappa = 0.4).
- Microcephaly and developmental delay were distinctive clinical correlates.
Conclusions:
- Clinical, EEG, and neuroimaging findings show fair agreement in diagnosing pediatric seizure disorders.
- EEG and neuroimaging are valuable tools in conjunction with clinical history.
- Identifying specific clinical correlates like microcephaly and developmental delay aids diagnosis.
Aim:
Electroencephalogram (EEG) is specific, but not sensitive, for the diagnosis of epilepsy. This study aimed to correlate the clinico-electrographic and radiological features of seizure disorders in children attending a tertiary care centre in northern India.
Methods:
Children aged between one to 18 years with seizure episodes were included. Clinical details, including historical as well as physical findings, were evaluated along with EEG and neuroimaging (Magnetic resonance imaging). Details were noted on pre-designed proforma. Variables were analysed by using appropriate statistical methods.
Results:
A total of 110 children with seizures were enrolled in the study. Male to female ratio was 1.6: 1, and the mean age of the study children was 8 years. The majority of the children were symptomatic for more than one year. The most common seizure type was Generalised Tonic Clonic Seizure (GTCS), and Hypoxic-ischemic Encephalopathy (HIE) sequelae was the most commonly attributed etiology, followed by neurocysticercosis. EEG and neuroimaging findings were found to correlate well with seizure semiology from history. The incidence of febrile seizures was 10% in this study, with nearly three-fourths of them being simple febrile seizures.
Conclusion:
Microcephaly and developmental delay were the most distinctive clinical correlates in children with seizures. There was a fair agreement between the types of seizures described in history and depicted on EEG with Cohen's kappa of 0.4. Also, there was a significant association between the type of seizures on EEG and the duration of symptoms.
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