CLINICAL PROFILE AND MANAGEMENT OUTCOMES OF PEDIATRIC SEIZURE DISORDERS: A HOSPITAL-BASED CROSS-SECTIONAL STUDY
Main Article Content
Keywords
pediatric seizures, epilepsy, febrile seizures, hospital-based study, clinical profile
Abstract
Introduction: Pediatric seizure disorders represent a significant neurological condition affecting 4-10% of children globally, with varying clinical presentations and etiological patterns across different populations. This study aimed to evaluate the clinical profile, demographic characteristics, and management outcomes of pediatric seizure disorders in a tertiary care hospital setting in North India.
Methods: A hospital-based descriptive cross-sectional study was conducted at Saraswati institute of medical sciences hapur, from July to December 2009. Children aged 1 month to 12 years admitted with seizure disorders were enrolled using consecutive sampling. Data were collected using structured questionnaires covering demographic details, clinical presentations, seizure characteristics, etiological factors, and treatment outcomes. Statistical analysis was performed using SPSS version 15.0.
Results: Among 215 children studied, 61.4% were under 2 years of age with male predominance (57.7%) and rural residence (72.6%). Generalized tonic-clonic seizures were most common (66.0%), followed by febrile seizures (17.7%). Fever-related etiologies predominated (41.4%), with idiopathic causes in 26.0% and CNS infections in 15.8% of cases. Associated fever was present in 57.7% of patients, with developmental delay noted in 20.9%. Complete seizure control was achieved in 77.7% of cases, with mortality of 3.7% and 19.1% lost to follow-up.
Conclusion: Pediatric seizure disorders predominantly affected infants and young children from rural, lower socioeconomic backgrounds. The high prevalence of fever-related and infectious etiologies emphasizes the need for enhanced infection prevention strategies and improved emergency care protocols in similar healthcare settings.
References
• Berg, A. T., & Shinnar, S. (1996). Complex febrile seizures. Epilepsia, 37(2), 126-133. doi: 10.1111/j.1528-1157.1996.tb00003.x
• Berg, A. T., Shinnar, S., Levy, S. R., Testa, F. M., Smith-Rapaport, S., & Beckerman, B. (1999). Early development of intractable epilepsy in children: a prospective study. Neurology, 53(5), 1045-1050. doi: 10.1212/WNL.53.5.1045
• Camfield, C. S., Camfield, P. R., Gordon, K., Smith, B., & Dooley, J. M. (1993). Outcome of childhood epilepsy: A population-based study with a simple predictive scoring system for those treated with medication. Journal of Pediatrics, 122(6), 861-868. doi: 10.1016/S0022-3476(09)90009-9
• Castro Conde, J. R., Hernández Borges, A. A., Doménech Martínez, E., González Campo, C., & Perera Soler, R. (2005). Midazolam in neonatal seizures with no response to phenobarbital. Neurology, 64(5), 876-879. doi: 10.1212/01.WNL.0000152895.80849.78
• Cowan, L. D. (2002). The epidemiology of the epilepsies in children. Mental Retardation and Developmental Disabilities Research Reviews, 8(3), 171-181. doi: 10.1002/mrdd.10035
• Datta, S. S., Premkumar, T. S., Fielding, S., Chandy, S., Kumar, S., Eagles, J., & Cherian, A. (2006). Impact of pediatric epilepsy on Indian families: influence of psychopathology and seizure related variables. Epilepsy & Behavior, 9(1), 145-151. doi: 10.1016/j.yebeh.2006.04.011
• Eriksson, K. J., & Koivikko, M. J. (1997). Prevalence, classification, and severity of epilepsy and epileptic syndromes in children. Epilepsia, 38(12), 1275-1282. doi: 10.1111/j.1528-1157.1997.tb01224.x
• Freeman, J. M. (1978). Neonatal seizures: diagnosis and management. Journal of Pediatrics, 93(3), 364-371. doi: 10.1016/S0022-3476(78)81231-X
• Hauser, W. A., Annegers, J. F., & Kurland, L. T. (1993). Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935-1984. Epilepsia, 34(3), 453-468. doi: 10.1111/j.1528-1157.1993.tb02586.x
• Hirtz, D., Ashwal, S., Berg, A., Bettis, D., Camfield, C., Camfield, P., ... & Shinnar, S. (2000). Practice parameter: evaluating a first nonfebrile seizure in children. Neurology, 55(5), 616-623. doi: 10.1212/WNL.55.5.616
• Huang, C. C., Chang, Y. C., & Wang, S. T. (1998). Acute symptomatic seizure disorders in young children--a population study in southern Taiwan. Epilepsia, 39(9), 960-964. doi: 10.1111/j.1528-1157.1998.tb01445.x
• Jensen, F. E. (1999). Acute and chronic effects of seizures in the developing brain: experimental models. Epilepsia, 40(Suppl 1), S51-S58. doi: 10.1111/j.1528-1157.1999.tb00881.x
• Knudsen, F. U. (2000). Febrile seizures: treatment and prognosis. Epilepsia, 41(1), 2-9. doi: 10.1111/j.1528-1157.2000.tb01518.x
• Kotsopoulos, I. A., van Merode, T., Kessels, F. G., de Krom, M. C., & Knottnerus, J. A. (2002). Systematic review and meta-analysis of incidence studies of epilepsy and unprovoked seizures. Epilepsia, 43(11), 1402-1409. doi: 10.1046/j.1528-1157.2002.t01-1-26901.x
• Lanska, M. J., Lanska, D. J., Baumann, R. J., & Kryscio, R. J. (1995). A population-based study of neonatal seizures in Fayette County, Kentucky. Neurology, 45(4), 724-732. doi: 10.1212/WNL.45.4.724
• Malik, B. A., Butt, M. A., Shamoon, M., Tehseen, Z., Fatima, A., & Hashmat, N. (2005). Seizures etiology in the newborn period. Journal of the College of Physicians and Surgeons Pakistan, 15(12), 786-790.
• McAfee, A. T., Landon, J., Schoenberg, B. S., & Baum, J. (2007). The incidence of first provoked and unprovoked seizure in pediatric patients with and without psychiatric diagnoses. Epilepsia, 48(6), 1075-1082. doi: 10.1111/j.1528-1167.2007.01108.x
• Millichap, J. G., & Millichap, J. J. (2006). Role of viral infections in the etiology of febrile seizures. Pediatric Neurology, 35(3), 165-172. doi: 10.1016/j.pediatrneurol.2006.06.004
• Mizrahi, E. M., & Kellaway, P. (1987). Characterization and classification of neonatal seizures. Neurology, 37(12), 1837-1844. doi: 10.1212/WNL.37.12.1837
• Murthy, J. M., & Yangala, R. (1999). Acute symptomatic seizures--incidence and etiological spectrum: a hospital-based study from South India. Seizure, 8(3), 162-165. doi: 10.1053/seiz.1999.0263
• Ronen, G. M., Buckley, D., Penney, S., & Streiner, D. L. (2007). Long-term prognosis in children with neonatal seizures: a population-based study. Neurology, 69(19), 1816-1822. doi: 10.1212/01.wnl.0000279335.85797.2c
• Shinnar, S., & Glauser, T. A. (2002). Febrile seizures. Journal of Child Neurology, 17(Suppl 1), S44-S52. doi: 10.1177/08830738020170010601
• Singh, G., Singh, P., Singh, I., Rani, A., Kaushal, S., & Avasthi, G. (2006). Epidemiologic classification of seizures associated with neurocysticercosis: observations from a sample of seizure disorders in neurologic care in India. Acta Neurologica Scandinavica, 113(4), 233-240. doi: 10.1111/j.1600-0404.2005.00575.x
• Sood, A., Grover, N., & Sharma, R. (2003). Biochemical abnormalities in neonatal seizures. Indian Journal of Pediatrics, 70(3), 221-224. doi: 10.1007/BF02725590
• Tekgul, H., Gauvreau, K., Soul, J., Murphy, L., Robertson, R., Stewart, J., Volpe, J., Bourgeois, B., & du Plessis, A. J. (2006). The current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants. Pediatrics, 117(4), 1270-1280. doi: 10.1542/peds.2005-1178
• Udani, V. (2005). Pediatric epilepsy--an Indian perspective. Indian Journal of Pediatrics, 72(4), 309-313. doi: 10.1007/BF02724012
• Verrotti, A., Latini, G., Cicioni, P., & de Felice, C. (2004). New trends in neonatal seizures. Journal of Pediatric Neurology, 2(4), 191-197.
• Volpe, J. J. (1989). Neonatal seizures: current concepts and revised classification. Pediatrics, 84(3), 422-428.
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Dr. Pradeep Kumar Jain
Assistant Professor, Department of Pediatrics, Saraswati Institute of Medical Sciences Hapur, Uttar Pradesh