Etiological profile of afebrile seizures in infants in a tertiary care center from southern India

Abstract

A bstract Introduction: Seizure is the most common neurological illness in pediatric population and its risk is highest in the first year of life. Studies regarding etiology of afebrile seizures worldwide and in India are limited; hence, the current study was undertaken. Objective: The objective of this work was to study the etiology of afebrile seizures in infants aged 1 month to 1 year. Materials and Methods: A retrospective study of afebrile infantile seizure was conducted at pediatric neurology outpatient department between January 2015 and September 2017. All children with first episode of afebrile seizures were included. Biochemical and hematological investigations, imaging, and electroencephalogram were performed whenever necessary. Simple descriptive statistics were used to analyze the data in the form of frequencies with percentages and median as applicable. Results: One hundred twenty-one children with a mean age of 8.1 months were analyzed. Of these children, 58% were males. Positive family history was found in 1.65% children, developmental delay in 70%, and dysmorphism in 8%. Presenting seizure type were generalized (74%), focal (21%), and unknown (6%) onset. Etiology was deducible in 92% cases. Structural etiology was the most common (66%), followed by metabolic (12%), infections (7%), and others (6%). In structural pathology, common causes were perinatal insult (38%) and cerebral malformations (18%). Imaging was done in 98 cases and yield was 83% (85 cases). Conclusion: Etiology was deducible in 92% of children. Seizures due to structural etiology, secondary to perinatal insult followed by metabolic and infections, are important causes. Imaging aids are important in etiological diagnosis. Etiological evaluation should be considered in children following first episode of afebrile seizures, especially in developing countries like India.

Diphtheritic Polyneuropathy: A Rare Complication that Needs to be Acknowledged

“…During the progression of the illness, autonomic disturbances such as sinus tachycardia, arterial hypotension, urine retention, significant xeroderma and hyperkeratosis, and hyperemia and hyperhidrosis may appear (Piradov et al 2001). The clinical manifestations of DP in children are not different from adults (Gowda et al 2022;Kanwal et al 2012;Manikyamba, Satyavani, and Deepa 2015).…”

“…Despite the availability of effective vaccinations, diphtheria has the potential to resurface. Poor immunization coverage, interruption of the cold chain, inadequate living conditions, delayed reporting to the health center, and non-availability or delay in the administration of antitoxin are likely to contribute to the recurrence of the disease and higher mortality (Gowda et al 2022;Jammar et al 2021). The waning of immunity in adults is playing a part as a risk factor for this condition.…”

A Research Study on Prompt Results and Physical Assessment of Mechanically Ventilated Children

“…[7] In contrast to previous research, where the prevalence of MV, encompassing non-invasive ventilation, was 23%, our study's incidence of MV, including this kind of ventilation, was 11.5%. [8,9] The range of PICUs' mechanical ventilation rates for pediatric patients is between 14 and 60%. [10][11][12] According to one research, 52% of children in PICUs in Sri Lanka got MV, however, other studies revealed that the prevalence of MV was 30% and 34.6%, respectively.…”

Profil épidémiologique, clinique, étiologique et évolutif des convulsions aiguës chez les enfants de 02 à 59 mois admis dans un hôpital de Bamako

“…Le neuropaludisme et les méningites étaient les étiologies les plus fréquemment retrouvées dans cette zone [1,21,23]. Selon la littérature, les facteurs de risque significativement associés à la survenue d'une méningite sont l'âge inférieur à 12 mois, la léthargie, l'irritabilité, les vomissements, la raideur de la nuque, la fontanelle bombée, les maux de tête, la somnolence, le coma, les convulsions complexes et l'utilisation antérieure d'antibiotiques [14,24,25]. Selon la littérature occidentale, les convulsions fébriles représentent la majorité des crises observées chez les enfants de moins de 5 ans [9,13,14].…”

“…Selon la littérature, les facteurs de risque significativement associés à la survenue d'une méningite sont l'âge inférieur à 12 mois, la léthargie, l'irritabilité, les vomissements, la raideur de la nuque, la fontanelle bombée, les maux de tête, la somnolence, le coma, les convulsions complexes et l'utilisation antérieure d'antibiotiques [14,24,25]. Selon la littérature occidentale, les convulsions fébriles représentent la majorité des crises observées chez les enfants de moins de 5 ans [9,13,14]. La prise en charge des crises consistait aux urgences pédiatriques par la libération des voies aériennes et l'administration de diazepam.…”