ACUTE SYMPTOMATIC SEIZURES IN ADULT INDIAN RURAL WOMEN: AN OBSERVATIONAL STUDY AND COMPARISON OF SEIZURE PROFILE WITH URBAN POPULATION

Abstract

Adult women presenting with acute symptomatic seizures for the first time compromise a significant component of seizure patients. Compared with men, they have a different hierarchy of etiologies and therefore different requirements in terms of evaluation and further treatment. These etiologies not only differ according to the geographical location (between North and South India), but also between urban and rural population. A study to elucidate the different etiologies in women will help the primary care physician to understand the various etiologies and provide appropriate treatment. This data would be useful to health organizations to take appropriate preventive measures to control and eradicate infective etiologies in rural population and educate the urban population about the life style diseases that predispose to seizures.

Material and Methods- A prospective observational cross- sectional study conducted at Rohilkhand Medical College and Hospital. The first 100 adult women, presenting with new onset symptomatic seizures were recruited.

Results- Infective etiology (67%), were most common cause, neurocysticercosis was commonest, followed by tuberculoma, viral meningoencephalitis and bacterial meningoencephalitis. Metabolic causes (15%) were second most common, with hyponatremia as commonest cause, followed by uremic encephalopathy, hypocalcemia and hypoglycemia. Cerebrovascular disease (9%) was the third most common, with arterial infarcts, followed by Intracerebral hemorrhage and cerebral venous sinus thrombosis. Miscellaneous causes (9%) were 3 tumors and  6 cases of Organophosphorus poisoning.

Conclusion- Infective causes are the leading cause of acute symptomatic seizures in adult rural women. Organophosphorus poisoning also is an important cause, which needs to be addressed by the primary health care provider. The etiology was different on comparison with studies in urban population, where cerebrovascular disease were the most common, due to increase prevalence  of lifestyle diseases in urban population, compared to the poor sanitation in rural population contributing to infections and thereby acute symptomatic seizures in adult  women.