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Etiological Profile of First Episode Seizures in Paediatric Patients at a Tertiary Care Centre: A Descriptive
Madhu Shah1, Saurav Poudel1, Bivusha Parajuli1
1Nobel Medical College Teaching Hospital, Biratnagar, Morang, Nepal.
Insights
Febrile seizures and neurocysticercosis are leading causes of first-time seizures in children in Eastern Nepal. Prompt diagnosis using neuroimaging and lab tests is crucial when simple febrile seizures are not suspected.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroscience
Background:
- Seizures represent a common pediatric neurological emergency and a frequent cause for hospital admissions.
- Understanding the specific causes and clinical patterns of first-time seizures in children is essential for effective management.
Purpose of the Study:
- To investigate the etiology, clinical characteristics, and immediate outcomes of children experiencing their first seizure in Eastern Nepal.
Main Methods:
- A prospective descriptive study was conducted over one year in a tertiary care center.
- 170 children aged 6 months to 15 years with a first-time seizure were enrolled using convenience sampling.
- Data collected included demographics, clinical presentation, seizure type, associated symptoms, family/trauma history, and diagnostic test results (neuroimaging, EEG).
Main Results:
- The majority of patients (72.36%) were male, with a mean age of 5.13 years; 61.18% were under five.
- Generalized tonic-clonic seizures were most common (77.64%), often accompanied by fever (88.23%).
- The primary etiologies identified were febrile seizures (54.17%), neurocysticercosis (15.88%), and meningitis (7.05%). Neuroimaging was abnormal in 30.59% of cases.
Conclusions:
- Febrile seizures, neurocysticercosis, infections, and trauma are significant causes of pediatric seizures.
- Diagnostic tools like lumbar puncture, neuroimaging, and laboratory tests are valuable for identifying seizure etiologies, especially when simple febrile seizures are not the cause.
Introduction:
Seizures are the most common neurological emergency and one of the most common reasons for paediatrics hospital admissions. This study aimed to identify the etiology, clinical profile, and immediate outcome of children with the first episode of seizure in Eastern Nepal.
Methods:
This was a prospective descriptive study carried out in the Tertiary Care Centre from September 2022 to August 2023. Ethical clearance was taken from the Institutional Review Committee (Ref no:654/2022). Convenience sampling was done to include 170 children presenting with the first episode of seizure at age 6 months to 15 years. Variables collected were demographics, clinical presentations, family history, trauma history, laboratory tests, neuroimaging, EEG, final diagnosis, and immediate outcome.
Results:
A total of 170 patients were admitted with the first episode of seizure with 123 (72.36%) males and 47 (27.64%) females. The mean age of the patients was 5.13±2.95 years with 104 (61.18%) patients under 5 years of age. The most common seizure was generalized tonic-clonic type in 132 (77.64%) patients. The most common associated symptom was fever in 150 (88.23%) children. Neuroimaging was abnormal in 52 (30.59%) patients, with neurocysticercosis seen in 27 (15.88%). The most common etiology was febrile seizure in 92 (54.17%) patients, neurocysticercosis in 27 (15.88%), and meningitis in 12 (7.05%).
Conclusions:
Febrile seizures, neurocysticercosis, infection, and trauma were the major causes of seizures in children. When simple febrile seizures were unlikely, lumbar puncture, neuroimaging, and laboratory tests were useful tools for diagnosing etiologies of seizures.
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