Study of etiology and clinical profile of patients presented with first episode of seizure

 

S P Toshniwal¹, S B Jagtap², V M Mohabe^3*, M V Kabara⁴

 

Abstract              Background: A first seizure is a frightening event for the individual, for onlookers and for family members. The diagnosis of such an event is common in everyday clinical practice. The knowledge of the etiologic risk factors of acute symptomatic seizures will invariably contribute to the effort aimed at preventing and managing medical conditions frequently complicated by seizures. The present study was undertaken to determine the etiology of the seizure and study the clinical profile of patients presenting with first onset seizures. Material and Methods: A total of 100 consecutive adult patients above 18 years of age presenting to the tertiary care hospital with first onset seizures. All patients were clinically evaluated and thorough clinical examination was done. Hematological, biochemical and radiological investigations were conducted. Depending upon the suspected etiology, patients also underwent certain specific investigations like CSF examination, serological tests, carotid angiogram – DSA and histopathological examination of biopsy specimen. Results: GTCS was the most common type of seizure accounted for 63% and focal seizures in 37% cases. Infections (35%) were the most common cause (Neurocysticercosis 14%, Tuberculoma 9%, Others 12%) followed by Vascular (29%) causes, Idiopathic seizures (17%), Metabolic (7%), Alcohol related seizures (11%). Males presented 2.8 times more often than females to the tertiary care hospital as first onset seizure. Peak incidence was seen in 26-45years age group. Discussion: Acute episode of seizures isone of the commonest causes of hospitalization with high morbidity and mortality. Most of acute symptomatic seizures are caused by CNS infections like neurocysticercosis and tuberculoma, which can be prevented with improvement in health care facilities.

Keywords: Seizure, first episode, etiology, infections, neurocysticercosis