ABSTRACT
Background: Epilepsy is one of the most prevalent neurological conditions among the elderly. Age-related epileptogenic disorders as well as the ageing itself pose a risk for seizures in the elderly. The lack of witnesses, non-specific symptoms, and transient symptoms make the diagnosis challenging in the elderly. Aim: This study aimed to assess the various presentation and aetiology for the seizure disorder in the elderly population. Materials and Methods: A total of 125 elderly patients ≥60 years with new onset seizure were included in the study. Demographic data, co-morbidities, and clinical presentation of seizure were elicited. Hemogram, liver and renal function tests, random blood sugar, electrolytes, and serum calcium were analysed. Computed tomography (CT), magnetic resonance imaging (MRI) brain, and electroencephalogram (EEG) were performed. Results: Seizure was seen predominantly in the males with age group of 60-70 years. Generalized tonic-clonic seizure was the commonest presentation, followed by focal seizures. The leading causes of seizures were cerebral vascular accidents, metabolic conditions, and alcohol. CT brain was abnormal in 49%, and 73% of the patients showed abnormality in MRI brain. EEG was abnormal in 17.3% of patients. Temporal lobe infarction was the commonest, trailed by parieto-temporal and frontal lobe involvement. Conclusion: Seizures in the elderly have varied clinical signs and aetiology. An awareness about these atypical presentation and aetiology is essential for the early diagnosis and management to prevent morbidity.
ABSTRACT
Background Dengue fever, more prevalent in Asia, is a highly neglected vector-borne disease. It has a varied presentation ranging from common fever to atypical presentation as encephalitis. This study aimed to analyze the demographic and clinical profile of dengue patients admitted to a tertiary care center in Tamilnadu. Methodology This retrospective study was performed by collecting patient data from the medical records department for the years 2012 to 2014. A total of 150 patients with 50 patients from each year were selected. The patient's demographic data, clinical profile, management, and outcome were noted. Patients were divided into three groups as per the World Health Organization's 2009 classification. Results Most dengue cases occurred from October to December (70.7%). The number of male and female patients was almost equal (77 [51.3%] and 73 [48.7%], respectively). The middle-aged group (21-40 years) was commonly affected (54%). The mean age was 29 ± 13.20 years. Fever was the most common symptom (100%), followed by lethargy (81.3%) and myalgia (60.7%). Overall, 10% of patients had comorbidities such as diabetes, hypertension, and ischemic heart disease. Moreover, 22.7% of patients had dengue with warning signs, and severe dengue was seen in 19.3% of patients. A significant difference was noted in the total count, comorbidities, serositis, and the duration of hospitalization between the groups. No mortality was recorded in the study population. Conclusions Dengue is very common in the middle-aged group. Patients with severe dengue had significant leucopenia, several comorbidities, and serositis. The mortality can be reduced to <1% and even zero in severe dengue according to our study with close monitoring and supportive care.
