Study of clinicodemographic profile of children with Epilepsy

 

 

Abstract               this study was done in 166 patients of epilepsy to evaluate clinicodemographic profile in form of incidence as a whole and type wise, age distribution and associated other morbidity with or without contributing factors in tertiary care centre, civil hospital, Ahmedabad.

Key Word: Epilepsy, generalized, focal, idiopathic, symptomatic

 

 

INTRODUCTION

Epilepsy is a condition characterized by recurrent (two or more) unprovoked seizures separated by more than 24 hours. Epilepsy is one of the most common serious disorders of the brain, affecting about 50 million people world-wide. At least 50% of cases begin at childhood or adolescence. One of every ten people will have at least one epileptic seizure during a normal lifespan, and a third of these will develop epilepsy. Epilepsy accounts for 1% of the global burden of disease; 80% of the burden of epilepsy is in the developing world, where in some areas 80-90% of people living with epilepsy receive no treatment at all. In India, the number of people living with epilepsy is almost 5 million. The prevalence rates of epilepsy in India are similar to those of developed nations. In India point prevalence of epilepsy is 5/1000. Epilepsy consists of more than seizures for the affected individual and immediate effects on his or her family. Epilepsy leads to multiple interacting medical, psychological, economic and social repercussions, all of which need to be considered in order to understand fully the impact of this condition. Fear, misunderstanding and the resulting social stigma and discrimination surrounding epilepsy often force people with this disorder “into the shadows”. Absenteeism in school leads to educational backwardness and poor school performance. When child grows as an adult they suffer from anxiety, depression, loss of job and difficulty in getting married due to social stigma. Majority of the patients can be treated with single antiepileptic drug and many children outgrow epilepsy as they become adult. This study is done to evaluate incidence, etio-pathogenesis and clinical profile of epilepsy.

 

MATERIAL AND METHODS

 Prospective analytic study done in indoor patients at a tertiary care center with detailed history and physical examination.

Inclusion criteria: Children between 1 month and 12 years of age who presented for the first time with epileptic seizures (i.e. recurrent unprovoked seizures) and admitted in pediatric care unit were included in study.

Exclusion criteria:

• Neonates were excluded from this study.
• Febrile seizures were excluded from this study.
• Conditions mimicking seizures (pseudo seizure) like breath holding spells, syncope, migraine, night terror, sleep walking etc. were excluded.
• Acute symptomatic seizure that does not recur once the acute cause has settled was not included. Details of present episode, relevant past and family history were elicited in each individual. History of perinatal events and development was collected in further detail. Physical examination findings were entered and child was subjected to base line investigations as per proforma. Specific investigations like EEG was done in all patients. Neuroimaging like CT/MRI was done as and when indicated in selected children. Patients were clinically classified according to ILAE 2010 classification. Appropriate therapy was given to all patients. The patients who did not respond to first line drugs were shifted to second line and third line drugs as per standard protocols.
• First line drugs: Sodium valproate, Carbamazepine, Phenobarbitone and Phenytoin sodium.
• Second line drugs: Topiramate, Levetiracetam, Clobazam, Clonazepam, Lamotrigine and Oxcarbazepine.
• Third line drugs: ACTH, vigabatrin, zonisamide and lacosamide.
• On follow up treatment, outcome and sequelae were monitored.

 OBSERVATION AND RESULTS

Table 1: Age of onset of first convulsion

 

Table 2: Distribution of types of epilepsy in various age groups

 

Table 3: Association with Family history

 

Table 4: Association of epilepsy with past history

 

 

Table 5: Type of epilepsy according to etiology

 

Table 6: Abnormal CNS findings

 

Table 7: Causes of symptomatic epilepsy