Umesh Joshi
Smt. NHL Municipal Medical College, India
Title: Clinico-etiological classification of epilepsy in children presenting to specialty epilepsy clinic at tertiary medical centre
Biography
Biography: Umesh Joshi
Abstract
Introduction: Epilepsy is one of the most urgent problems in pediatric neurology. Asserting the causes and types of seizure is important for diagnostic purposes and for evaluating therapy. Objectives: To identify the clinical & etiological profile of children and the characteristics of seizures in them along with therapeutic responses.
Methods: All patients who attended the epilepsy clinic & fulfilled the selection criteria were enrolled in study. This is a descriptive study of 12 months (June’15–June’16) & involved analysis of records of the patients who came to specialty OPD. Three groups were formed accordingly–focal, generalized & unknown onset with further etiological sub-divisions-Genetic, Structural/Metabolic, Immune, Infectious & Unknown.
Results: In all, 417 patients were studied. The distribution as per clinical presentation was- group I (generalized) 215 (58.5%)–group II (focal) 154 (36.9%), and group III (unknown) 48 (4.6%). The main etiologies were perinatal asphyxia (28.3%), NHBI (11.4%) in (structural–metabolic) sub group. In Genetic & Infectious, Channelopathies (10.5%) & Post Meningitis Sequelae (4.7%). 56.3% of the patient in group II were on more than 3 AEDs. 14.3% in group I were weaned of AEDs. 61.4% patients in group II were having neuro-developmental sequelae. EEG revealed abnormal activity in 30 (6.2%) in group I & 31 (19.3%) in group II. Maximum patient with refractory epilepsy were seen in group III.
Conclusion: To have a good management of epilepsy, we need to have multi-dimensional classification of epilepsy based on both clinical & etiological spectrum. Perinatal asphyxia & NHBI are one of the most common yet avertible etiologies.