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Background: The objective of this study is to utilize the ILAE 2017 to classify epilepsy patients and determine its applicability in Sudan. Methods: This study is a prospective, descriptive, cross-sectional research conducted in two pediatric epilepsy clinics in Khartoum State, Sudan. Results: In this cross-sectional study, 350 pediatric patients with epilepsy were included, with a mean age of 8.4 ± 4.7 years and a mean illness duration of 4.71 ± 3.91 years. The ILAE classification was applied, showing that 71.11% of patients had generalized onset seizures, 27.7% had focal onset seizures, and only 1.1% had unknown onset seizures. Among patients with focal onset seizures, 56.4% had intact awareness, while 43.6% had impaired levels of awareness. The majority of patients who had generalized onset seizures experienced motor onset seizures, with tonicclonic seizures being the most common (44.2%). Nearly all patients with unknown onset seizures experienced tonic-clonic convulsions. These findings provide insights into the prevalence and types of seizures among pediatric epilepsy patients in Sudan and can guide clinicians in developing appropriate treatment plans. Conclusion: This study highlights the importance of utilizing the latest ILAE classification 2017 in epilepsy classification and its potential utilization in resource limited areas like Sudan.
Subject(s)
Humans , Male , Female , Child, Preschool , Seizures , Classification , ElectroencephalographyABSTRACT
Background: Seizure is a common problem evaluated in pediatric emergency departments. Seizure disorders are among the most frequent neurologic problems that occur in childhood. Around 4 to 10% of children experience at least one episode of seizure in the first 16 years of their life. Objectives: To study clinical and etiological profile of children presenting with seizures. Material and Methods: A total of 126 consecutive children aged 1 month to 18 years presenting with seizures defined as per international league against epilepsy classification, participated in this study. A detailed history was taken, and clinical examination was done, along with the investigation for the aetiology of seizures with routine and specific tests, computerized tomography (CT) scan and/or magnetic resonance imaging (MRI) and electroencephalography (EEG) as and when needed. Results: In our present study, we recorded the highest incidence of seizures in the age group of 1year to 5 years. The incidence of seizures in our study was more in males, accounting for 73 cases (57.4%) while females were 53 cases (42.06%). Generalized seizures were the commonest, among them GTCS accounting for 88 cases (69.84). The identified major etiologic factors were febrile convulsions followed by CNS infections. Conclusion: The incidence of convulsions is highest in the age group of 1 month to 5 years and in males. The commonest type of seizure is generalized tonic-clonic (40.6%).The most common cause of convulsion is febrile seizures. Milestones were achieved normally in majority of cases.
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Background: Overall incidenceof seizure is found to be 0.2-0.6 per 1000 population per year. A first seizure mandates individual counselling about the risk of recurrence, the pros and cons of drug treatment. Seizures are usually a manifestation of an underlying pathology which may be genetic, structural or metabolic.Objectives of current study wereto study the clinical profile of new onset seizures in adults (greater than 19 years) attending to tertiary care Centre, Mysore and to determine the etiology of new onset seizures in adults reporting to tertiary care centre, Mysore.Methods:All participants fulfilling the inclusion criteria were interviewed as per proforma. Participant抯 demographic, social and medical details were recorded in proforma sheet and patients were subjected to neuroimaging studies, EEG and other necessary blood investigations. In all cases the seizure type is classified according to ILAE Classification 2017.Results:Among 100 cases evaluated for new onset, Majority of the patients were 41 to 60 years. Generalised seizures (95%) were more common than focal seizures.Among neurological etiological causes, vascular causes (34%) were most common. Most common Non-neurological cause for seizures was alcohol withdrawal (46.67%).Conclusions: If proper analysis of etiologyis made, seizures can be treated accordingly thus reducing the morbidity and mortality associated with it. Primary care physicians play a pivotal role in identifying patients with adult onset seizures and should encourage these patients to undergo neuroimaging so as to arrive at an appropriate etiological diagnosis.
ABSTRACT
BACKGROUND: Since 1985 when ILAE proposed its first classification system of epilepsy, many studies have reported the practical applicability of the system. However, its limitations have been elucidated. In order to find out the applicability and limitations of the ILAE classification system and the role that diagnostic parameters (semiology, EEG and MRI) take in the anatomical localization of localization-related epilepsies (LREs), we investigated the clinical data of adult patients with LRE in step-wise way. METHOD: We recruited 173 patients with newly-referred/diagnosed LRE from our departmental data registry. Idiopathic epilepsies were excluded. We evaluated the anatomical localization rate(LR) according to each diagnostic parameter, the concordant localization rate(CLR) between two parameters and between three parameters. LR in total patients by any one of three diagnostic parameters was also evaluated. MRI abnormalities were evaluated in those patients showing concordant localization between semiology and EEG. RESULTS: The highest anatomical LR(67.1%) was reported in the semiological parameter. CLR between semiology and EEG was 28.9%. CLR between three parameters was 16.2%. MRI abnormalities were seen in 60% of patients with concordant localization between semiology and EEG. Fifty six percent of electroclinically concordant patients showed concordant localization with an MRI and 79% of them were concordantly localized in the temporal lobe. The LR in total patients was 71.7%. In each of the evaluation steps, the temporal lobe LR was the highest. CONCLUSIONS: Total lobar LR by any one diagnostic parameter in all the patients was high according to the ILAE diagnostic criteria. Semiology was the best localizing parameter, however, combined evaluation with either EEG or MRI reduced the localizability. Even though the MRI study showed a significant discordance rate in patients with electroclinical localizations, it could identify the underlying etiology in a major proportion of the patients. This study showed the importance of an imaging study in the lobar localization of LREs combined with an electroclinical localization by the ILAE classification system.