A clinical study of new onset seizures in children aged 3-12 years

Background: Seizures are common in pediatric age group and less than 1/3rd of seizures in children are caused by epilepsy. Aim of present study was to analyze the etiological factors and clinical profile of new onset seizures in children aged 3-12 years.Methods: This was a prospective study done at a tertiary care center of south India. Authors analyzed 98 children aged 3-12 years presenting with new onset seizures. Proper history and investigations including EEG, and CT brain were done to confirm the etiology.Results: Out of 98 children 51 were 3-5 yrs of age and 47 were 6-12 years. 66.3% had generalized seizure and 33.6% had partial seizure. Partial seizure were more common in 5-12 years of age. Intracranial infections were the leading cause (73/98) which included neurotuberculosis (26/73), NCC (20), bacterial meningitis (12), cerebral malaria (8) and viral encephalitis (7). Intracranial infections' were the' leading cause in both age groups. Space occupying lesions were more common in 6-12 years (46.8%) as compared to 3-5 years (19.6%). NCC and Tuberculoma were the leading CT findings in both age groups. There was significantly high incidence of focal EEG changes in partial seizure group compared to generalized seizure group.Conclusions: Intracranial infections were leading cause of new onset seizures especially GTCS. Good clinical evaluation and judicious use of investigations should be ensured. CT brain and EEG are more likely to be informative in partial seizures than in generalized seizures.

Recurrent Complex Partial Seizures in a Patient with Progressive Multifocal Leukoencephalopathy

Seizures are less frequent in progressive multifocal leukoencephalopathy (PML), because it is considered to be restricted to the white matter. In addition, types of seizures in patients with PML are mostly convulsive, and seizures are usually present at the time of diagnosis or early in the course of disease. We report a case of chronic PML with recurrent complex partial seizures in the absence of motor component.

Recurrent Complex Partial Seizures in a Patient with Progressive Multifocal Leukoencephalopathy / 대한간질학회지

Seizures are less frequent in progressive multifocal leukoencephalopathy (PML), because it is considered to be restricted to the white matter. In addition, types of seizures in patients with PML are mostly convulsive, and seizures are usually present at the time of diagnosis or early in the course of disease. We report a case of chronic PML with recurrent complex partial seizures in the absence of motor component.

Clinical Significance of Interictal Serum Prolactin Level in Male Patients with Complex Partial Seizures Involving Temporal Lobe

BACKGROUND: To investigate the clinical significance of interictal serum prolactin level (ISPL), especially in the medical intractability, in patients with complex partial seizure involving the temporal lobe. METHODS: Forty-one male patients older than 16 years, who had motionless staring, were selected. The patients were divided into paired groups according to medical intractability, secondary generalization, duration of disease, seizure frequency, number of antiepileptic drugs, hippocampal sclerosis in MRI, and interictal epileptiform discharge. Serum was sampled in the morning before breakfast, and ISPL was measured. RESULTS: ISPL of the medically intractable patients (11.43 +/- 1.25 ng/ml, n=23) was relatively higher than the treatable patients (9.67 +/- 1.52, n=18), but it was not statistically significant (p>0.05). ISPL of the patients with secondary generalization was significantly higher (11.58 +/- 1.10, n=33) than that of the patients without secondary generalization (6.84 +/- 1.39, n=8; p=0.049). The other factors did not make significant changes in ISPL (p>0.05). CONCLUSIONS: The medical intractability of epilepsy with clinically determined complex partial seizures involving temporal lobe did not change the ISPL. Therefore, ISPL may not be useful as a biochemical marker of the medical intractability of complex partial seizures involving the temporal lobe. However, there was the evidence suggesting that the secondary generalization of complex partial seizures may be an important factor to increase ISPL, which implies that more widespread robust activation of limbic structures may be needed to elevate ISPL.