Epidemiological study of Paediatric Seizures and Its Management in Paediatric Emergency Department.

ABSTRACT

Introduction: Pediatric seizures are a common occurrence and frequent presentation to emergency department (ED). Seizures result from paroxysmal involuntary disturbance of brain function. The history and physical examination guide us to manage and assist in differentiating seizures from nonepileptic disorders. Methodology: This study was carried out to know the trends of paediatric seizures and their management in ED. We had included all patients less than 12 years of age with seizures, admitted to our hospital's pediatric ED between May and August 2012. All demographic findings, seizure characteristics and laboratory findings were recorded. Results: A total of 53 children were enrolled in the study of which 38 (71.7%) children were male and 15 (28.3%) were female. The mean age of presentation was 2.42 years. 66.7% of patients had generalized seizures and 33.3% of patients had partial seizures. Out of total study population, 49% had febrile seizures and 20.8% had afebrile seizures. The majority of seizures (69.8%) lasted less than 10 minutes of which 54% were afebrile. Status epilepticus (SE) was found most commonly in 30.2% children. Out of 16 patients with SE 10 (62.5%) were less than two years of age. The common causes of SE were fever, Central Nervous System (CNS) infection, and epilepsy, accounting for 31.3%, 37.5% and 31.2% respectively. The children with underlying CNS abnormalities (cerebral palsy) had poorer outcomes. Mortality found in SE (9.4%) was related to an acute neurologic insult or a chronic CNS condition. Metabolic abnormalities were detected in 28.3% patients. The frequency of metabolic abnormalities was significantly higher in patients under two years of age (66.7%). 53.7% had hypocalcemia, 33.3% had hypoglycaemia and 20% had hyponatremia. MRI (Magnetic resonance imaging) of brain or EEG (electroencephalogram) or both was carried out in only 13.2% patients. 85% of patients had undergone laboratory investigations. Lumbar puncture was performed in 26.4% patients.