Profile of First Time Seizure in Infants with 1 to 12 Months of Age Presenting to a Tertiary Care Pediatric Hospital

Abstract

The incidence of seizure in first year of life is very high. Considerable research on neonatal seizures has been done; however information regarding the profile of patients with first time seizure in the age group of 1 to 12 months is scarce. Our study was a prospective observational study undertaken at a tertiary pediatric care hospital in north India with objectives of finding the epidemiological, clinical, and aetiological profile of patients in the age group of 1 to 12 months presenting with first time seizure and to ascertain their electroencephalography (EEG) and imaging findings. Seizure recurrence and developmental delay was also studied during the first six months post seizure. Fifty patients were included in the study. There were 31 male patients (62%) and 19 female patients (38%). Mean age at seizure occurrence was 5.3 ±2.1 months. Forty one patients (82%) presented with generalized tonic seizures. Only two patients (4%) had focal seizures. Seizures in 7 patients (14%) could not be classified. Electroencephalography and brain imaging were done in 42 patients as indicated. Among these 42 patients, EEG abnormalities were noted in 15 patients (35.7%), while imaging abnormalities were noted in 10 patients (23%). Fifteen patients (35.7%) were found to have developmental delay on follow-up. 16 (38%) patients developed recurrence of seizures. Statistical analysis revealed significant association between abnormal imaging and developmental delay at six months and seizure recurrence within six months of first seizure, however the association with abnormal EEG was not statistically significant.

Keywords

infant seizures - developmental delay - seizure recurrence - EEG - imaging

• References

• 1 Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia 1994; 35 (Suppl. 02) S1-S6
• 2 Jensen FE. Neonatal seizures: an update on mechanisms and management. Clin Perinatol 2009; 36 (04) 881-900, vii
• 3 Phatak P. . Developmental Assessment Scales for Indian Infants (DASII) – Revised Baroda Norms Manual, 1997
• 4 Mukhopadhyay K, Malhi P, Mahajan R, Narang A. Neurodevelopmental and behavioral outcome of very low birth weight babies at corrected age of 2 years. Indian J Pediatr 2010; 77 (09) 963-967
• 5 Taneja V, Sriram S, Beri RS, Sreenivas V, Aggarwal R, Kaur R. Not by bread alone': impact of a structured 90-minute play session on development of children in an orphanage. Child Care Health Dev 2002; 28 (01) 95-100
• 6 Beghi E, Carpio A, Forsgren L. , et al. Recommendation for a definition of acute symptomatic seizure. Epilepsia 2010; 51 (04) 671-675
• 7 Durá Travé T, Yoldi Petri ME, Gallinas Victoriano F. Incidence of epilepsy in 0-15 year-olds [in Spanish]. An Pediatr (Barc) 2007; 67 (01) 37-43
• 8 Russ SA, Larson K, Halfon N. A national profile of childhood epilepsy and seizure disorder. Pediatrics 2012; 129 (02) 256-264
• 9 Ahmed S, Alam ST, Rahman MM, Akhter S. Clinical profile of early childhood epilepsy: a cross sectional study in a tertiary care hospital. Mymensingh Med J 2016; 25 (01) 96-101
• 10 Adhikari S, Sathian B, Koirala DP, Rao KS. Profile of children admitted with seizures in a tertiary care hospital of Western Nepal. BMC Pediatr 2013; 13: 43 . Doi: 10.1186/1471-2431-13-43
• 11 Nikunj NK, Mishra D, Juneja M, Talukdar B. Etiology and short-term outcome of first seizure in hospitalized infants. Indian Pediatr 2016; 53 (10) 924-926
• 12 Rasool A, Choh SA, Wani NA, Ahmad SM, Iqbal Q. Role of electroencephalogram and neuroimaging in first onset afebrile and complex febrile seizures in children from Kashmir. J Pediatr Neurosci 2012; 7 (01) 9-15
• 13 Kalnin AJ, Fastenau PS, deGrauw TJ. , et al. Magnetic resonance imaging findings in children with a first recognized seizure. Pediatr Neurol 2008; 39 (06) 404-414