Incidence and risk factors for seizures in central nervous system infections in childhood

Abstract

INTRODUCTION: The infections of the central nervous system remain as a public health problem in several countries and there is a direct relation between poverty and underdevelopment with high mortality and morbidity rates. Seizures represents a complication related to infections of the central nervous system, are considered a clinical emergency and requiring neurological investigation. OBJECTIVE: In this article, we propose to describe the incidence and risk factors for seizures in central nervous system infections in childhood. METHODS: a retrospective study was performed between October 2007 and October 2008 and all patients who were hospitalized with the diagnosis of infections of the central nervous system were analyzed. Newborns were excluded. The patients were divided into GROUP 1 (without seizures) and GROUP 2 (with seizures). RESULTS: 731 patients were included, 47.75% males, with average age of 15.7 years. GROUP 1 - with fever (652/92.35%), headache (580/82.15%), vomits (550/77.9%), and viral meningitis predominance (652/93.06%). GROUP 2 - with fever (25/100%), vomits (12/48), headache (6/24%), and viral encephalitis predominance (14/56%). Ten (40%) patients from the GROUP 2 presented EEG alterations. The incidence of seizures was 3.42% and a significant statistical difference was noticed related to mean age (p<0.000069), presence of headache (p<0.0000), vomits (p<0.0005), stiff neck (p<0.0105) and drowsiness (p<0.0265). CONCLUSIONS: the occurrence of seizures during the hospitalization is significantly more frequent in cases of viral encephalitis and bacterial meningitis compared to viral meningitis. The risk of seizures increases in early ages. Headache, vomits, stiff neck and drowsiness are more frequent symptoms in children with infection of the central nervous system who presented seizures during the hospitalization.

MRI characteristics of intracranial masses in the paediatric population of KwaZulu-Natal: A neuroimaging-based study

“…The majority (80%) of inflammatory masses also presented with seizures, which is a known clinical presentation. 14,15 Tumour-related seizures result from metabolic, neurotransmitter and morphologic changes in the peritumoural brain, as well as the presence of peritumoural products, gliosis and necrosis. Neurological excitation from pro-inflammatory signals causes seizures from inflammatory masses.…”

Association of Meningitis among Children with First Attack of Fever and Seizure without Clinical Manifestations of Meningitis

“…In current practice, lumbar puncture in infants with febrile seizures without clinical symptoms of meningitis is not obligatory. Therefore, American academy of pediatrics has changed its criteria of 1996 about lumbar puncture in children under 1 month of age in 2009 as if any infant falling in the age group of 6-12 months present with seizure and fever, a lumbar puncture is optional when the child is considered having deficiency of H influenza type B or streptococcus pneumonia immunization or when history of immunization is not known, because of increased risk of bacterial meningitis 6,7 . This study intends to determine the frequency of meningitis among children of age group 1-18 months with occurrence of first attack of fever and seizures without clinical manifestation of meningitis because the consequences of missing even solitary case of meningitis will be dreadful and the early detection may avert sinister consequences.…”

Mood disorders associated with Anti Epileptics

“…It is defined as having two or more unprovoked seizures. Seizures are the result of excessive discharges in a group of brain cells [2]. A "case study" which has briefly construed in this article at succeeding stages, emphases on epilepsy and associated psychiatric comorbidities; mood disorders are most common culprit of it [3].…”