Clinical Pattern of Seizures in the Out Patient Pediatric Neurology Clinic of Al- Hussein University Hospital

Samier Saleh, Ezzat; Kafafy Abd Elghaffar, Aida; Abdullah Elsayeh, Abd Elsattar; Hemeda Moustafa, Amr

doi:10.21608/azjp.2020.128345

Clinical Pattern of Seizures in the Out Patient Pediatric Neurology Clinic of Al- Hussein University Hospital

Document Type : Original Article

Authors

10.21608/azjp.2020.128345

Abstract

Background: Seizures are the most common pediatric neurological disorder. Up to10% of children suffer from at least one episode of seizure in the first 16 years of life. The incidence is highest in children less than 3 years of age, with a decreasing frequency in older children (Friedman and Sharieff, 2006). Febrile seizure is the most common form of seizures in childhood, affects 2-5% of all children across the world (Sampaio et al., 2010). Incidence of first non-febrile seizure in children is 25,000 to 40,000 per year in the United States (Martindale et al., 2011).
Objectives: We aimed to clarify the clinical pattern of seizures including their type, frequency, possible etiology, family history, level of controlling seizure, parents awareness about seizure precaution and home management and antiepileptic drug used 'in pediatric neurology clinic of Al- Hussein University Hospital.
Patients and Methods: This descriptive study was carried out on 200 patients with seizures disorder, from outpatient clinic of pediatric neurology at Al-Hussein University Hospital, during the period from April 2019 to October 2019. All patients were aged from 1 month up to 18 years and of both genders, newly and old diagnosed cases. Patients less than 1 month and more than 18, and mentally retarded children were excluded. History-taking, complete clinical examination and laboratory investigations were registered. Electroencephalography was done. Adequate rationale AED was given.
Results: At the time of interview, of the 200 patient with seizure disorder had age ranges from 1 month -18 years, male more than female (124 (62%) vs. 76 (.38%)) with a male/female ratio 2:1, the most common age for onset of seizures was within the first year of life (56.50%) of all patients, Parental consanguinity was reported in 4.5%. Family history of epilepsy was reported in 9.5%, that most seizures in our patients without triggers (59.0%) followed by fever (30.0%), the most common percentage of our Seizure was Controlled in (65.00%). About 46% reported genetic etiology for epilepsy, 29.5% reported structural etiology with the most common cause Hypoxic ischemic encephalopathy (16%). CNS infection (23%), perinatal complications (birth asphyxia) (2%) and head trauma (1.5%) were identified in the symptomatic group. Febrile seizures were reported in 20.5%. Main seizure types were generalized in 70% and focal with or without focal to bilateral in 17.5%. The generalized motor tonic clonic seizures were frequent in generalized epilepsy (67.5%). Rolandic epilepsy was the most frequent type of age specific epileptic syndrome (4.5 %). Most of our patients (90.00%) were not awareness about seizures precaution and home management. MRI brain findings were normal in 17 .00 %, and Abnormal in 37 % with predominant abnormality was brain atrophy in 46 %.