DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20202147

Study of intracranial structural lesions diagnosed by computed tomography among children with unprovoked seizure disorder

Priyanka Choudhary, Amit Kumar Mital, Sheela Sinha

Abstract


Background: Seizures are the most common pediatric neurological disorder. The objectives were to know the prevalence and types of intracranial structural lesions diagnosed by Computed Tomography in children with unprovoked seizures.

Methods: It is hospital based cross-sectional study done in Patna Medical College, India from August 2005- July 2007. All patients aged 6 months to 12 years admitted in pediatrics department with at least 2 episodes of unprovoked seizures were undergone Computed Tomography brain.

Results: Out of total 112 patients admitted, 66.1% had abnormal CT scan. Prevalence of abnormal CT scan increased with advancing age and significant, with maximum percentage found in age group 10-12 years (43.2%). Males had more seizures and intracranial lesion than females but this association was statistically non-significant. 65.2% had generalized seizure and 34.8% had partial seizure. Among patients with abnormal CT scan, generalized seizure (70.3%) and partial seizure (29.7%).The commonest  probable diagnosis was tuberculoma (47.3%) followed by neurocysticercosis (25.7%) and brain abscess (4%). Other were atrophy, gliosis and hydrocephalus, 2.5% each; arachnoid cyst, extradural hematoma, sturge weber syndrome, tuberous sclerosis, infarct, hemiatrophy, caudate lobe hemorrhage, basal ganglia calcification, corpous callosum agenesis, 1.35% each.

Conclusions: Inflammatory granuloma is the leading cause of unprovoked seizure in this part of the country. Every seizure case should undergo a CT scan examination. Preventive measures can be applied for tuberculoma and NCC so as to lower down the burden of seizure disorder.


Keywords


Children, Computed tomography brain, Intracranial structural lesion, Unprovoked seizure

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References


McAbee GN, Walk JE. A practical approach to uncomplicated seizures in children. An Fam Physicians. 2000;62(5):1109-16.

Newton CR, Garcia HH. Epilepsy in poor regions of the world. Lancet. 2012;380(9848):1193-201.

Guerrini R. Epilepsy in children. Lancet. 2006;367(9509):499-524.

Udhani V. Pediatric epilepsy-An Indian Prespective. Indian J Pediatr. 2005;72:309-13.

Kapoor M, Talukdar B, Chowdhury V, Puri V, Rath B. Intracranial Structural Lesions in Young Epileptics: A Computed Tomographic Study. Indian Pediatrics. 1998;35:537-41.

Kumar R, Navjivan S, Kohli N, Sharma B. Clinical correlates of CT abnormality in generalized childhood epilepsy in India. J Trop Pediatr. 1997;43:199-03.

King MA, Newton MR, Jackson GD, Fitt GJ, Mitchell LA, Silvapulle MJ, et al. Epileptology of first seizure presentation: a clinical, electroencephalographic and magnetic resonance imaging study of 300 consecutive patients. Lancet. 1998;352:1007-1.

Shinnar S, O'Dell C, Mitnick R, Berg AT, Moshe SL. Neuroimaging abnormalities in children with an apparent first unprovoked seizure. Epilepsy Res. 2001 Mar 1;43(3):261-9.

Hirtz D, Ashwal S, Berg A, Bettis D, Camfield C, Camfield P, et al. Practice parameter: evaluating a first nonfebrile seizure in children: report of the quality standards subcommittee of the American Academy of Neurology, The Child Neurology Society, and The American Epilepsy Society. Neurol. 2000 Sep 12;55(5):616-23.

Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia. 1989;30(4):389-99.

Bhavani EG, Ramesh TV. Prevalence of neuroimaging abnormalities in children with new onset afebrile seizures in tertiary care hospital. J. Evolution Med Dent Sci. 2016;5(48):3066-9.

Ashraf M, Irshad M, Chowdhary J, Malla RA, Akhter Y. Computed tomographic study in young epileptics in Kashmir, India. Al Ameen J Med Sci. 2013;6(3):272-7.

Mathur S, Southern K, Sharma M. Significant findings on cranial CT scan after a first unprovoked seizure in children from North India. J Tropic Pediatr. 2007 Dec 1;53(6):428-30.

Maytal J, Krauss JM, Novak G, Nagelberg J, Patel M. The role of brain computed tomography in evaluating children with new onset of seizures in the emergency department. Epilepsia. 2000 Aug;41(8):950-4.

Poudel P, Gupta MK, Kafle SP. Computerized Axial Tomography Findings in Children with Afebrile Seizures: A Hospital Based Study at Eastern Nepal. J Nepal Health Res Counc. 2017 Jan;15(35):61-6.

Ndubuisi CA, Mezue WC, Ohaegbulam SC, Chikani MC, Ekuma M, Onyia E. Neuroimaging findings in pediatric patients with seizure from an institution in Enugu. Niger J Clin Pract. 2016;19:121-7.

Fallah R, Moghadam RN, Tafti MF, Nodoushan MS. Results of Noncontrast Brain Computed Tomography Scans of 1-18 Year Old Epileptic Children. Iranian J Child Neurol. 2012;6(3):33.

Wammanda RD, Anyiam JO, Hamidu AU, Chom ND, Eseigbe EE. Computerized tomography of children with seizure disorders. Niger J Clin Pract. 2009;12:25-8.

Patel NH, Jain AR, Iyer VK, Shah AG, Jain DA, Shah AA. Clinico – diagnostic and therapeutic relevance of computed tomography scan of brain in children with partial seizures. Ann Indian Acad Neurol. 2013;16(3):352-6.