Study of Seizure Disorder in Children in Correlation With Computerized Tomography and Electroencephalography

Abstract

BACKGROUNDSeizure disorders are fairly common in children. Almost 5% of children at risk of experiencing a seizure. The aetiology of seizures is different in India and other developing countries as compared to the developed world. Tuberculoma and neurocysticercosis have relatively high frequency in India. 1 Most of the Indian studies on seizure disorders were done in mixed population of adults and children. Only few Indian studies looked at the prevalence, incidence, causative factors and other aspects of childhood seizures. The present study emphasizing on clinical profile of seizures concentrating only on paediatric age group and to evaluate the role of EEG and CT scan brain as a diagnostic aid in various seizure disorders in children. This study focusses on CT findings, which are more easily available in peripheries where MRI facilities may not be available, though MRI may be superior to CT in identifying the lesions. STUDY METHODSThe study includes 108 children from 1 year to less than 12 years of age with various seizure disorders, who are coming to Paediatric Outpatient and Inpatient Department, Govt. General Hospital, Kakinada, from November 2014 to October 2015. This is a cross sectional observation study. RESULTSOut of the 108 cases studied, half of the patients (n=55, 50.9%) presented with GTCS. Complex partial seizures is the second most common type of seizure disorder (n=29, 26.9%). Maximum number of children were in the 3-10 years' age group (n=65, 60.18%). Maximum number of patients presented during 12 th year (n=17, 15.7%) followed by 8 th year (n=14, 13%). Out of 108 children studied, 70 (64.81%) are male children and 38 (35.19%) are female children. The male:female ratio is 1.8:1. Among the patients with abnormal CT, solitary tuberculoma was the most frequent abnormality which was detected in 22 patients (40%), Neurocysticercosis was the second common abnormality detected in the present study. Among the patients with abnormal EEG, features suggestive of generalized seizure disorder was present in 39 cases (60.94%). One hemisphere slowing suggestive of underlying focus is present in 25 cases (39.06%), left side being involved in more number of patients than the right side. In the present study among patients with GTCS, EEG abnormality alone was found in 25.45% cases, CT abnormality alone was found in 23.64% cases and both CT and EEG were abnormal in 21.82% cases. CONCLUSIONSeizure disorders were found to be more common in male children compared to female children. The male:female ratio is 1.8:1. 2 The incidence of seizure disorders was found to be high in children above 3 years of age. Generalized seizures were more common than partial seizures. Among the generalized seizures, generalized tonic clonic seizures were common and among partial seizures complex partial seizures were common. In the present study, CT scan revealed structural abnormalities more commonly in partial seizures (74%) than in generalized seizures (41%). The most common finding observed by CT scan was tuberculoma follo...