Abstract
Background: Seizures are an important cause of morbidity and mortality in childhood. It is therefore important to establish accurate diagnosis of seizures and its aetiologies to appropriately manage such patients. Neuroimaging can help to determine whether a seizure in a patient results from a structural abnormality of the brain or its surroundings. It is useful in a variety of clinical settings. The present study was undertaken to find the role of computed tomography (CT) scan in identifying non-neoplastic cause of seizure disorders in children.
Materials & Methods: It was a hospital based cross sectional observational study. Age, sex, characterization of seizure including onset, time of attack ,provocative factors, first attack, total no of attacks, frequency of attack, status of consciousness, prodrome, aura, cerebellar symptoms, duration, post ictal phenomenon, history of drug intake, control of attack by drugs, family h/o of seizure, birth history were noted.
Results: In the present study 34.5% of children belong to 6-9 yrs age group followed by 27.6% of 16-18 yrs group. Most common type of seizure was generalised tonic clonic seizures (29.31%) followed by complex partial (25.86%), simple partial (17.24%) and unclassified/epilepsy syndromes (13.79%).About 46.55% of cases CT for detection of lesions were useful in our study.
Conclusion: Though the MRI is more specific in detecting certain focal anomalies its expense and non-availability make CT scan an adequate initial screening procedure. Thus every child with a seizure should be subjected to a CT scan to determine the underlying aetiology and offer specific treatment.
Keywords: Seizure disorders, Non-neoplastic aetiologies, Computerized tomography, Neuroimaging.
References
- Binnie CD. Electroencephalography. In: John L, Alan R, Jolyn O, editors. A text book of epilepsy, 3rd Edn.Churchill Livingstone; 1988. pp. 236–237.
- Pellock JM. The paediatric clinics of North America.WB Saunders; 1989. (Editor). Seizure disorders. IX Vol 36 No 2 (April).
- Kanitkar M, Purkayastha SB, Deshpande ND. Role of CT scan in partial seizures in children. Med J Armed Forces India. 2017; 50(1):23-26.
- Cavazzuti GB. Epidemiology of diferent types of epilepsy in school aged children in Medene. Italy, Epilepsia. 1980; 21:57–59.
- Sofijanow NG. Clinical evaluation and prognosis of childhood epilepsies Epilepsia. 1982; 23:61–63.
- Todt H. The late prognosis of epilepsy in childhood-Results of a prospective follow up study. Epilepsia. 1984; 24:137–139.
- Amudhan S, Gururaj G, Satishchandra P. Epilepsy in India I: Epidemiology and public health. Ann Indian Acad Neurol. 2015; 18(3):263-77.
- Banerjee TK, Ray BK, Das SK, Hazra A, Ghosal MK, Chaudhuri A, et al. A longitudinal study of epilepsy in Kolkata, India. 2010; 51:2384–91.
- Goel D, Agarwal A, Dhanai JS, Semval VD, Mehrotra V, Saxena V, et al. Comprehensive rural epilepsy surveillance programme in Uttarakhand state of India. Neurol India. 2009; 57:355–6.
- Radhakrishnan K, Pandian JD, Santhoshkumar T, Thomas SV, Deetha TD, Sarma PS, et al. Prevalence, knowledge, attitude, and practice of epilepsy in Kerala, South India. 2000; 41:1027–35.
- Shah PA, Shapoo SF, Koul RK, Khan MA. Prevalence of epilepsy in school-going children (6-18 years) in Kashmir Valley of North-west India. J Indian Med Assoc. 2009; 107:216–8.
- Bharucha NE. Epidemiology of epilepsy in India. 2003;44(Supp 1):9–11.
- Gadgil P, Udani V. Pediatric epilepsy: The Indian experience. J Pediatr Neurosci. 2011;6(Suppl 1):S126-9.
- Cendes F, Theodore WH, Brinkmann BH, Sulc V, Cascino GD. Neuroimaging of epilepsy. Handb Clin Neurol.2016; 136:985-1014.
- Engel International League Against Epilepsy (ILAE). A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: Report of the ILAE task force on classification and terminology. Epilepsia. 2001; 42:796–803.
- G D Casino, C R Jack, Neuroimaging in Epilepsy Principal & Practice, 1st edition, Butterwoth – Heineman, Boston -1996. Matthias Hoffer, CT Imaging manual, 3rd Edition. p -26
- Bogdanoff BM, Stafford CR, Green L, Gonazales CF. Computerised transaxial tomography in the evaluation of patients with focal epilepsy. Neurology (Minneap) 1975; 25:1013–1017.
- Bachman DS, Hodges FJ, Freeman JM. Computerised Axial Tomography of the brain in chronic seizure disorders of childhood. 1976; 58:828–832.
- Wadia RS, Makhale CN, Kelkar AV, Grant KB. Focal epilepsy in India with special reference to lesions showing ring or disc like enhancement on contrast computed tomography. Journal of Neuro, Neurosurg and Psychiatry. 1987; 50:1293–1301.
- Maytal J, Krauss JM, Novak G, Nagelberg J, Patel M. The role of brain computed tomography in evaluating children with new onset of seizures in the emergency department. Epilepsia. 2000 Aug; 41(8):950-4.
- Baheti R, Gupta BD, Baheti R. A Study of CT and EEG findings in Patients with Generalised or Partial Seizures in Western Rajasthan. JIACM 2003; 4(1): 25-9.
- Pohlmann-Eden B, Beghi E, Camfield C, Camfield P. The first seizure and its management in adults and children. BMJ : British Medical Journal. 2006; 332(7537):339-342.
- Bronen RA, Fulbright RK, Spencer DD, et al. Refractory epilepsy: comparison of MR imaging, CT, and histopathologic findings in 117 patients. Radiology 1996; 201:97–105.
- Bronen RA, Fulbright RF, Spencer SS, Spencer DD, Kim JH, Lange RC. Comparison of MR and CT imaging of refractory epilepsy: Correlation with postoperative seizure outcome in 109 patients. Int J Neuroradiol 1997; 3:140-146.
- Yang PJ, Berger PE, Cohen ME. Computerised tomography and childhood seizure disorders. Neurology. 1979; 29:1084–1089.
- Recommendations for neuroimaging of patients with epilepsy. Commission on Neuroimaging of the International League against Epilepsy. Epilepsia. 1997; 38(11):1-2.
- Gaillard WD, Chiron C, Cross JH, Harvey AS, Kuzniecky R, Hertz-Pannier L, et al. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia. 2009; 50(9):2147-53.
- Kumar R, Kohli N, Thavnani H, Kumar A, Sharma B. Value of CT scan in the diagnosis of meningitis. Indian Pediatr. 1996; 33(6):465-8.
- Chaudhary, G. and Chaudhary, V. 2017. Evaluation of role of computed tomography scan brain in children with generalized seizures. Indian Journal of Child Health Nov. 2017; 3(1): 36-38.
- Murthy JM, Yangala R. Acute symptomatic seizures - Incidence and etiological spectrum: A hospital-based study from South India. Seizure. 1999; 8(3):162-5.
Corresponding Author
Dr Sheela Kandulna (Goswami)
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