Radiological and Electrophysiological Abnormalities in children presenting with afebrile seizures in a tertiary care centre

Dr. K.Umamaheswara Rao; Dr .S.R.R.Madhurya

Volume : VI, Issue : I, January - 2017

Radiological and Electrophysiological Abnormalities in children presenting with afebrile seizures in a tertiary care centre

Dr. K. Umamaheswara Rao, Dr . S. R. R. Madhurya

Abstract :

BACKGROUND: The present study aims at determining the frequency of radiological (Neuroimaging) and electrophysiological (EEG) abnormalities in children admitted with afeile seizures and also to determine the most common cause of these abnormalities. METHODOLOGY: The present study included 96 children presenting with afeile seizures between the age groups of 2months to 10 years admitted to PICU, Pediatric department of Alluri Sitarama Raju Academy of Medical Sciences Hospital, Eluru, during the period of two years from Dec 2014 to Sep 2016. Seizures were classified based on latest terminology laid by ILAE (Berg et al.)1 2010. All the children were subjected to EEG and either CT/MRI (with or without contrast) or both. The subsequent findings helped in determining the cause of afeile seizures. RESULTS: Afeile seizures were more commonly found in males when compared to females. Higher percentage of children in the present study group hailed from rural areas which were resource limited. 42.7% of the study group belonged to the age group of 6months– 4 years. In the age groups 6months– 4yrsand 4–6yrs GTCS was most common. whereas between 6–8yrs, and 8–10yrs Focal seizures were more common. The frequency of radiological (Neuroimaging) abnormalities was determined to be 76%. which indicates that Neuroimaging is necessary in afeile seizures. Most common cause of radiological (Neuroimaging) abnormalities was determined as Cereal Palsy 59.4%, followed by Neurocysticercosis 11.4%. Cortical Atrophy was the most common radiological abnormality observed in children with Cereal Palsy. In Neurocysticercosis single lesions (91%) were most commonly observed. The Frequency of EEG abnormalities in the present study was 53.2%. of In cases presenting with GTCS, EEG abnormalities were observed in 73.4% followed by Focal seizure with impairment of consciousness 37.9%. Different patterns of EEG observed were: Generalized epileptiform discharge (68.6%), Focal epileptiform discharge (25.4%), Multifocal (4%), Others (Burst Suppression) (2%). Cereal palsy and Neurocysticercosis were determined to be one of the common causes of acquired epilepsy. Most common Cause of Radiological (Neuroimaging) and Electrophysiological Abnormalities was Cereal Palsy (84.3%) and the 2nd most common was Neurocysticercosis (2.6%). CONCLUSION: Radiological (Neuroimaging) And Electrophysiological(EEG) abnormalities are common in afeile Seizures. Eitiology of afeile seizure are (Neuroinfections, Neurocysticercosis, Metabolic causes, Neurotrauma following Adverse perinatal events (Birth Asphyxia) etc) Most of these are treatable (like Neuroinfections, Neurocysticercosis). ) and are easily picked up in Neuroimaging. Future epilepsy can be predicted by EEG as it proved to be a sensitive modality in picking up abnormalities and treatment can be accordingly given.