Study of different variable and outcome in early and late onset childhood epilepsy
Journal Title: Medpulse International Journal of Pediatrics - Year 2018, Vol 8, Issue 1
Abstract
Background: Epilepsy is a chronic neurological disorder outcome of childhood epilepsy differs among early onset (onset before one year) and late onset (onset after one year) childhood epilepsy. There is a paucity of data regarding intractable epilepsy in India, especially in children. Early identification of clinical predictors of intractable epilepsy according to age of onset of seizures would help in counseling patients and their families, selecting patients for intensive investigations and treatment with recently approved treatment as earliest and also to consider surgical and other non surgical treatments. This study was done to observe the variable of outcome of early and late onset childhood epilepsies. Methods: Children with epilepsy between age 1mths to 12yrs attending to the epilepsy clinic at Departments of Paediatrics government medical college, Aurangabad were included in this study. Age, sex, family history of epilepsy, age of onset and the underlying illness were recorded for all cases, as well as details of the seizure history, duration, frequency, semiology, past history of seizures and drug history, birth history, developmental milestones recorded from all participants. Detail general examination, anthropometry, neurological examination and examination of co-morbid conditions conducted meticulously. They were divided into early onset group (onset of seizures before one year) and late onset group (onset of seizures after one year). Neuroimaging and EEG done in all cases. Blood samples were collected for complete blood count, liver function test and renal function test from all participants. All participants were following up regularly for clinical examination at 4 weekly intervals and blood parameters at 3 monthly intervals. Antiepileptic drugs were given to all epileptic children by the supervision of paediatrician. Polytherapy was given when monotherapy failed. They were asked to follow up in between if any new neurological symptoms, seizures and other new symptoms develop in participants the two group were observed for period of 2 year January 2016 to January 2018. Results: 234 patients were analyzed. Out of them 92 patients had early onset epilepsy and the rest 142 had late onset epilepsy. In early onset group 66.3% were males and 33.7%were females, while in late onset group males 55.6%andfemales were 44.4% Duration of epilepsy at follow up were same in both groups. generalised mode of onset were commonest in both groups 58. 6 % and 78. 8% in early and late onset groups respectively spasms as a mode of onset were seen in early onset group only. Status epilepticus at first presentation were almost same in both groups. Developmental delay intellectual disability and microcephaly were seen commonly in early onset group as compared to late onset group. Family history of epilepsy commonly observed in late onset group i.e. 23.9 %.Perinatal history of encephalopathy where more commonly observed in early onset group i.e. 63%. EEG abnormalities at the time of presentation were commonly recorded in early onset group Etiological MRI findings were observed in two groups which showed following observations. Hypoxic ischemic encephalopathy were commonest etiological MRI findings in early onset group while post encephalitis sequele were commonest etiological finding in late onset group. Congenital anomalies of neuronal migration and brain anomalies where commonly observed in early onset group. MRI finding suggestive of tuberous sclerosis where observed in early onset group only while neurocysticercosis and hippocampal abnormality observed in late onset group. Mesial temporal sclerosis were observed in late onset group exclusively. Conclusions: In this study Developmental delay intellectual disability and microcephaly were seen commonly in early onset group. Congenital anomalies of neuronal migration and brain anomalies where commonly observed in early onset group. Complete remission were more commonly observed in late onset group as compared to early onset group. Intractable outcome were more commonly observed in early onset group
Authors and Affiliations
Amol Suryavanshi, Shilpa Pawar, Smita Mundada
Keywords
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- EP ID EP443985
- DOI 10.26611/1014816
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