Clinical profile and evaluation of seizures in adults presenting to our hospital

                   INTRODUCTION

● Seizures beginning in adult life require special attention with regard to their etiology as most of them are secondary to some underlying etiology. 

● These are mainly due to trauma, central nervous system (CNS) infections, space-occupying lesions, cerebrovascular accidents (CVA), metabolic disorders, and drugs.

 ● Unlike idiopathic seizures that are common in childhood.Identifying etiology and type of seizures plays an important role in decision making of therapeutic options available ,duration of therapy ,prognosis and recurrence .Thereby decreasing morbidity and mortality.

Aims and objectives: 

  1. To analyze the clinical profile and to evaluate the patients with new onset seizures .

Study design : 

Retrospective observational study conducted during 2020-2021.

Materials and methods : 

● Materials - Detailed history ,physical examination,RFT ,EEG ,MRI Brain ,CSF,serology and other routine investigations. 

● Methodology- In Patient with new onset seizures along with history and clinical examination,special investigations like CT /MRI BRAIN,EEG,CSF analysis will be done to find out etiology.

INCLUSION CRITERIA : 

1.patient more than 18 years of age 

2.New onset of seizures

 3.Status Epilepticus 

EXCLUSION CRITERIA :

  1.Psychogenic seizures

  2.Traumatic brain injury

  3. obstetric causes 

 4.Post operative seizures.

Observation and Analysis : 

1) Age and Gender distribution : 

 

● In our study - majority of patients were in age group of 41-50 years (n=17) followed by 21-30 years (n=13) .

● 88 % patients were in 2nd to 5th decade ,8.3 % in age group more than 60 years.

 ● Out of 60 patients studied 40 were males and 20 were females with male to female ratio 2:1.

 

2) Distribution of etiologies : 

● Among the distribution of various etiologies in seizures ,CVA is the leading cause which accounted for 30 % followed by metabolic causes - 25 %,CNS infection 20% ,alcohol withdrawal 16 % . 

3) Correlation of etiologies in age group :

 

● CVA and metabolic seizures are  more  common in elderly people

 ● In 18-20 yrs age group -most common etiology  was CNS infection 

● In 21-30 yrs age group most common etiology were Metabolic and infection. 

● In 31-40 yrs  and 41-50 yrs age group most common etiology was CVA . 

● In 51-60 yrs age group most common etiology was metabolic,followed by CVA.

4)various types of cva : 

●Among CVA infarct is most common etiology (61 %) followed by hemorrhage 22 % .

 

5) Various metabolic causes : 

● Among metabolic causes, uremia is the most common etiology 46% followed by hyponatremia 26% 

6) Various types of neuroinfection : 

●Among CNS infection most common is neurocysticercosis 50% ,followed by meningoencephalitis 25 % .

7) ETIOLOGY AND SEIZURE TYPE  : 

●Most common type of seizure overall is Generalised tonic clonic seizure(76 %).

 

                      Results of the study 

• In this study ,a total of 60 patients with new onset epilepsy were included.

• Sex ratio - There was a slight male preponderance   (M:F =2:1) in this study as quoted by other studies on epilepsy in United States and Europe (Granieri et al,1983).

• Age distribution- In our study - majority of patients were in age group of 41-50 years (n=17) followed by 21-30 years (n=13) .

• Type of seizures:GTCS were more common than focal seizures .

• Etiology of seizures : Among the distribution of various etiologies in seizures ,CVA is the leading cause  which accounted for 30 % followed by metabolic causes - 25 %,CNS infection 20% ,alcohol  withdrawal 16 % .

 REFERENCES 

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3.Kaur S, Garg R, Aggarwal S, Chawla SP, Pal R. Adult onset seizures: Clinical, etiological, and radiological profile. J Family Med Prim Care 2018;7:191-7

4.Bharucho NE. Epidemiology of epilepsy in India. Epilespia 2003; 44(1):9-11 5.Sitajayalakshmi S, Mani J, Borgohoin, Mohondas S. Post stroke epilepsy. Neurol India 2002; 50(Suppl.1) S78- S84.,

6.Dhonuka AK, Misra UK, Kalita J. Seizures after stroke: a prospective clinical study. Neurol India 2001; 49(1): 33- 36.

7. Shinton RA, Gill JS, Zezuulka AV, et al. The freque ncy of epilepsy preceding stroke; case control study in 230 patients. Lacnet 1987; 1: 11- 13.

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9.Títoff V, Moury HN, Títoff IB, Kelly KM. Seizures, Antiepileptic Drugs, and CKD. Am J Kidney Dis. 2019 Jan;73(1):90-101. doi:

 

Case report links : 

https://docs.google.com/document/d/1TDskl6xcJM58Y_jPYnM9OCngyGZr7JvE6KwUuJLHqWg/edit?usp=drivesdk

https://docs.google.com/document/d/1eZl1AJFbc5UBHvZ7w8nXdFHNNiJqTt3Bu2b8_XDpX30/edit?usp=drivesdk