Title: Study of Etiological Causes of New Onset Seizure with Special Reference to Types of Seizure
Authors: Dr Shishir Pandey, Dr Manoj Kumar Kushwaha, Dr M.H.Usmani, Dr Rakesh Patel, Dr Manoj Indurkar
DOI: http://dx.doi.org/10.18535/jmscr/v4i10.04
INTRODUCTION: Etiological spectrum of acute symptomatic seizures in developing countries is different from developed countries. The major etiological risk factors were central nervous system (CNS) infections (32%), metabolic disorders (32%) and cerebrovascular diseases (21%).1 Presently CNS infections like malaria, meningitis, tuberculosis, Human Immunodeficiency Virus (HIV) and neurocysticercosis account for significant number of cases in developing countries.2 Since these infections vary from region to region; etiology of seizure may also vary from region to region. AIMS AND OBJECTIVE: 1.To study the etiological profile of new onset seizures. 2. To study the distribution of various types of seizures and its correlation with etiological profile. MATRIALS AND METHODS: 100 patients admitted with new onset seizures from the hospital attached to S. S. Medical College, REWA and study conducted from july 2014 to October 2015. Eyewitness and patient are interviewed regarding seizure and clinical examination and routine investigation done, with special investigation like CT, MRI, EEG in selected cases. Result was analysed statically and mean and standard deviation was calculated. RESULT: Neuroinfections were the leading cause of seizure, which accounted for 31%, followed by Cerebrovascular accidents 26%, metabolic 22%, Idiopathic 10%, Tumours 6% and miscellaneous causes 5%.The most common cause for GTCS (83% of all cases) was CVA in (30.12%) followed by neuroinfection in (26.5%), metabolic in (20.48%), idiopathic in (12.04%), miscellaneous in (6.02%) and least common was tumours (4.8%). Type of seizures in Neuroinfection patients were GTCS in (70.96%) followed by Focal Seizures without dyscognitive features in (16.12%) and Focal Seizures with dyscognitive features in (6.45%). CVA patients presented with GTCS in (96.15%) followed Focal Seizures without dyscognitive features (3.84%). Metabolic seizures presentimg as GTCS were 77.27% followed by Focal seizure with secondary generalisation (13.63%). Tumours presenting with GTCS were 66.66%, followed by Focal Seizures without dyscognitive features in 16.66% of cases and Focal Seizures without dyscognitive features in 16.66% of cases. All of the idiopathic seizures and seizures in Poisoning were GTCS. CONCLUSION: Neuroinfection (31%) were the leading cause of new onset seizure which mainly present as focal seizure. CVA (26%) is second most common cause which mainly present as GTCS. Also Neuroinfection can be easily prevented by maintaining good hygiene, sanitary conditions and avoiding open defecation. KEYWORDS: Seizure, neuroinfection, GTCS, focal seizure.
Abstract