DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20212470

A study of clinical, etiological and neurodevelopmental profile of epilepsy in children aged 0-5 years

Vaishali R. Chanpura, Hardev T. Mori

Abstract


Background: Seizures constitute the most common neurological problem in children. Appropriate diagnosis and management of childhood epilepsy is essential to improve quality of life in them. Objectives of the study were to study the clinical and etiological profile of early childhood epilepsy and its effect on neurodevelopment.

Methods: This was a time bound study; duration being one year from September, 2018 to September 2019. All new patients with acute seizures or status epilepticus admitted in paediatric emergency ward were evaluated and those meeting inclusion criteria were enrolled. On the basis of history, neurological and systemic examination and available investigations primary diagnosis of epilepsy was reached. Neurodevelopmental parameters like vision, hearing, and DQ were assessed. EEG was done in all patients. Other relevant investigations like neuroimaging were carried out when indicated. Collected data was analysed in form of frequency and percentage.

Results: A total of 52 patients were enrolled. 60% patients were younger than 2 years. Maximum patients had generalised convulsions; generalised tonic-clonic being the most prevalent. 38% patients had significant perinatal complications like perinatal asphyxia, pyogenic meningitis and kernicterus. Fifty per cent patients had delayed milestones and half of those had severe delay. 67% had abnormal EEG and 20 patients had abnormal neuro-imaging findings. The most common etiologies for epilepsy were hypoxic ischaemic encephalopathy, idiopathic, epilepsy syndromes, metabolic disorders and CNS infections.

Conclusions: Majority of early childhood epilepsy is a result of either genetic conditions or perinatal events. They have neurodevelopmental and behavioural associations. While treating epilepsy all these factors should be considered in order to ensure a near-normal life for these patients.


Keywords


Epilepsy, Paediatrics, Neurodevelopmental profile

Full Text:

PDF

References


Pal DK. Epilepsy control in the 21st century: leave no child behind. Epilepsia. 2003;44:273-5.

Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-82.

Santosh NS, Sinha S, Chandra SP. Epilepsy: Indian perspective. Ann Indian Academy Neurol. 2014;17(1):S3-11.

Udani V. Pediatric Epilepsy-An Indian perspective. Indian J Pediatr. 2005;72:309-13.

Shah KN, Rajadhyaksha SB, Shah VS, Shah NS, Desai VG. Experience with the ILAE classification of epileptic seizures (1981) and epilepsies and epileptic syndrome (1989) in epileptic children in a developing country. Epilepsia. 1992;33:1072-7.

Udani VP, Dhanidharka V, Nair A, Oka M. Difficult to control epilepsy in childhood- a long term study of 123 cases. Indian Pediatr. 1993;30:1199-206.

Kim LG, Johnson TL, Marson AG. Prediction of risk of seizure recurrence after a single seizure and early epilepsy: further results from the MESS trial. Lancet Neurol. 2006;5:317-22.

Cowan F. Neonatal Hypoglycaemia: Role in infantile epilepsy. Indian Pediatr. 2009;46.

Neil WP, Hemmen TM. Neurologic Manifestations of Hypoglycemia, Prof. Everlon Rigobelo (Ed.). 2011;978-53.

Udani V, Munot P, Ursekar M, Gupta S. Neonatal hypoglycaemic brain injury - a common cause of infantile-onset remote symptomatic epilepsy. Indian Pediatr. 2009;46:127-32.

Burns CM, Rutherford MA, Boardman JP, Cowan FM. Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycaemia. Pediatrics. 2008;122:65-74.

Barkovich AJ, Ali FA, Rowley HA, Bass N. Imaging patterns of neonatal hypoglycemia. AJNR Am J Neuroradiol. 1998;19:523-8.

Iqbali T, Jaiswal AK, Kumar A. Clinical profile of children presented with seizure in tertiary care hospital PMCH Patna, a retrospective study. Int J Med Paediatr Oncol. 2016;2(3):107-12.

Gupta A, Desai C. Profile of Epilepsy in a tertiary care public sector hospital of western India. Int j Community Med Public Health. 2017;4(7):2520-24.

Khreisat WH. Clinical profile of the epilepsy during the first two years of life. Pak J Med Sci. 2017;22(1):55-9.

Ballesteros JR, Mishra OP, McGowan JE. Alterations in cerebral mitochondria during acute hypoglycemia. Biol Neonate. 2003;84:159-63.

Volpe JJ. Cerebral white matter injury of the premature infant-more common than you think. Pediatrics. 2003:112(1-1):176-80.

Wood NS, Marlow N, Costeloe K. Neurologic and developmental disability after extremely preterm birth. EPICure study group. N Engl J Med. 2000;343(6):378-84.

McBride MC, Laroia N, Guillet R. Electrographic seizure in neonates correlates with poor neuro-developmental outcome. Neurol. 2000;55(4):506-13.

Austin JK, Caplan R. Behavioural and Psychiatric Comorbidities in Pediatric Epilepsy: Toward an Integrative Model. Epilepsia. 2007;48(9)1639-51.

Ford P, Meltzer H, Goodman R. The British Child and Adolescent Mental health survey 1999: The prevalence of DSM-IV disorders J Am Acad Child Adolescent Psychia, 19994:42(10):1203-11.

American epilepsy society. Behavioural and intellectual disabilities in pediatric epilepsy. Available at: Sciencedaily.com/releases/2014/12/141208152354.htm. Accessed on 10 Jan, 2020.

Bruck I, Antoniuk SA. Epilepsy in Children with Cerebral Palsy. Arq Neuropsiquiatr. 2001;59(1):35-9.

Brodie MJ. Medical therapy of epilepsy: when to initiate and combine. J Neurol. 2005;252:125-30.

O’Dell’s. Initiation and discontinuation of AEDs. Neurol Clin. 2001;19:289-311.

Ahmed S, Alam ST, Rahman MM. Clinical profile of early childhood epilepsy: A cross sectional study in a tertiary care hospital. Mymensingh Med J. 2016;25(1).

Russ SA, Larson K, Halfon K. A National profile of Childhood Epilepsy and Seizure Disorder. Pediatrics. 2012;129:2.

Census of India. 2011. Available at: www.censusindia.gov.in. Accessed on 10 Jan, 2020.

Chiabi A, Nguefack S, Mah E. Risk factors for Birth Asphyxia in an Urban Health Facility in Cameroon. Iran J Child Neurol. 2013;7(3):46-54.