Study of Clinico-Etiological Profile of New-Onset Seizure in Infants

New-onset seizures in children between one month and one year of age have a diverse etiology. Their long-term prognosis depends on multiple factors like underlying cause, types of seizures, associated comorbidities like delayed development, and genetic and familial factors. A systematic evaluation of these cases is required for planning investigations, initiation of therapy, and counselling of parents about prognosis.

To study clinico-etiological profile of infants from one month to one year of age who presented with new-onset (first episode) of seizures at a tertiary care hospital.

This cross-sectional observational study was conducted over 12 months at the Department of Paediatrics, M.G.M. Medical College and M.Y. Hospital, Indore. A total of 100 infants between one and 12 months who presented with the first episode of seizure were studied. Clinical evaluation, management, and appropriate investigations were conducted as per the unit protocols. Data were entered in a predesigned proforma with special reference to seizure semiology, results of EEG, MRI, and developmental screening using the Trivandrum Developmental Screening Chart (TDSC). Statistical analysis was performed using SPSS version 22.

Among the 100 infants, 62% were aged between seven and 12 months and 62% were male. The most common etiology was febrile seizures (35%), followed by epilepsy (21%), meningitis (13%), metabolic causes (12%), structural brain malformations (4%), cerebral palsy (3%), and other causes (12%). Generalized tonic-clonic seizures were the predominant type (71%), with focal seizures in 23% and myoclonic in 6%. EEG abnormalities were noted in 22% of infants, and MRI abnormalities in 32%. Fever (52%) was the most frequent presenting symptom. Developmental delay, as per TDSC, was observed in 11% of cases. Seizure control was achieved in 97% of infants, while 3% had refractory seizures. A statistically significant association was found between etiology and seizure outcome (P = 0.001), but not with seizure semiology (P = 0.845).

Febrile seizures were the leading cause of new-onset seizures in infants, followed by epilepsy and infections. Most infants demonstrated favorable seizure control, with only a minority developing refractory epilepsy or developmental delays.