Etiologic Analysis of Adult Onset Seizure

ABSTRACT

A clinical study was done on 161 patients (male 94, female 67) with the first onset of seizure over the age of 16 who were admitted to Keimyung University Hospital from 1979 to 1983 in order to analyze the causative factors, the age distribution at onset, the seizure pattern and E.E.G. findings. The results were summarized as follows. 1. The etiological factors of 161 seizure patients revealed metabolic encephalophaties 75 cases (46.6%), cerebrovascular disease 26 cases (16.2%), unknown cause 21 cases (13%), CNS infectious disease 17 cases (10.6%), posttraumatic seizure 12 cases (7.5%), brain tumor proved by brain biopsy 8 (5%) and hysteric seizure 2 cases in order of frequency. 2. Among the 75 cases of metabolic encephalopathies, the most common cause was drug intoxication (34 cases), followed by alcohol withdrawal seizure (21 cases), water intoxication (5 cases), uremia and hypocalcemia (4cases respectively), hepatic encephalopathies (3 cases) and then hypoglycemia and anoxia (2 cases respectively) in order of frequency. Among the 26 cases of cerebrovascular disease, spontaneous subarachnoid hemorrhage was presented in 9 cases, intracerebral hemorrhage and cerebral infarction in 7 cases respectively and arteriovenous malformation in 3 cases. Among the 17 cases of CNS infectious diseae, meningitis was presented in 9 cases, Japanese B encephalitis in 3 cases, paragonimiasis in 2 cases, and then cerebral cysticercosis, tuberculoma, and focal cerebritis in 1 case respectively. Among the 8 cases of brain tumor, meningioma was presented in 5 cases, oligodendroglioma, glioblastoma multiforme and epidermoid cyst in 1 case respectively. 3. The mean age at the onset of each causes of seizure revealed metabolic encephalopathies 38 yrs. CNS infectious disease 33 yrs, posttraumatic seizure 34 yrs, arteriovenous malformation 23 yrs, brain tumor 42 yrs, and cerebrovascular disease 54 yrs. 4. The most frequent seizure pattern of 161 patients was the generalized seizure in 126 cases (78.3%) followed by the partial elementary seizure in 29 case and the partial seizure with secondary generalization in 6 cases. The incidence of partial seizure was slightly higher than the generalized seizure in brain tumor and CNS infectious disease. 5. There were no correlation between the E.E.G. degree and causative factors of seizure.