Rajendran, A (2013) Clinical and Etiological profile of Epilepsy with onset within the first three years of life in a Tertiary Care Hospital. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: Epilepsy is a common neurological disorder. It affects nearly 50 million people worldwide without any national, geographical, ethnical, age and sex boundaries. The disease burden of epilepsy is 1 percent and it causes 6.4 million disability-adjusted life years (DALYs) worldwide and it causes 1.32 million years of life (YLL) loss. Almost 80 percent people with epilepsy living in developing country including India. As of now, 6 to 10 million people are suffering from epilepsy in India. Epilepsy is one of cost intensive disorder. It causes huge burden to the individuals, health care providers and society at large. The first year of human life is associated with the highest incidence of epilepsy. During infancy a unique interface exists between epilepsy and normal brain maturation. The causes of remote symptomatic seizure, occurring in early childhood are different from adults, it also differs in developing countries like India comparing to developed countries. Only very few studies are available from India and no such study is available from this part of the country. So it is important to know the clinical and etiological profile of epilepsy in our children, which will help in adopting effective and better strategies for epilepsy management and prevention or modifications of various factors relating to epilepsies. AIM OF THE STUDY: 1. To study the clinical profile of epilepsy in patients with onset of epilepsy in the first three years of their life in a tertiary care hospital. 2. To study the etiology of epilepsy in patients with onset of epilepsy in the first three years of their life in a tertiary care hospital. MATERIALS AND METHODS: Study Design: Descriptive study. Study population: People with epilepsy attending outpatient clinic (OPD) in Department of Neurology & Paediatric Neurology at Government Stanley Medical College, Chennai. Study period: February 2012 to January 2013. Place of Study: Department of Neurology and Department of Paediatric Neurology, Govt. Stanley Medical College, Chennai, Tamil nadu. Inclusion Criteria: All epileptic patients with onset of seizure within the first three years of their life and continue to have seizures (2 or more seizures), irrespective of their present age. Exclusion Criteria: 1. Febrile seizure patients, 2. Epilepsy following febrile seizures, 3. Patients with seizure onset above the age of three years, 4. Uncertain about the age of onset of seizures, 5. Patient without MRI brain imaging, 6. Patient unwilling to participate in this study were excluded. CONCLUSION : Our study empathetically establishes the contribution of perinatal encephaloclastic conditions particularly hypoxichypoglycemic injuries as an important cause of the early childhood onset epilepsies. Mode of delivery and Institutional delivery did not have the expected impact in reducing perinatal hypoxic-hypoglycemic brain injuries and it emphasises the need to improve quality perinatal care among institutional deliveries in our country. Delayed cry at birth, newborn admission, low birth weight, delayed initiation of newborn feeding are the significant risk factors for perinatal encephaloclastic conditions. Focal epilepsy, particularly focal epilepsy of extra temporal origin is the commonest epilepsy type observed. In addition to perinatal encephaloclastic conditions (43.5%) and other symptomatic epilepsies (9.5%), 47% of patients had non lesional epilepsies. Nearly 50% of patients were on polytherapy. In developing countries like India, the perinatal factors still play a major role in the causation of infantile and early childhood onset remote symptomatic epilepsy. Perinatal hypoxia and undiagnosed neonatal hypoglycemia are potentially preventable risk factors for the development of the same. Hence quality perinatal care may be the need of the hour to prevent early onset childhood epilepsy in a large group of patients. Further care of these patients, may also need comprehensive epilepsy care units for optimal management of epilepsy and related issues in these patients in tertiary care hospitals. These above measures would help to alleviate the morbidity and socioeconomic burden associated with epilepsy in these patients.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.16101052 |
| Uncontrolled Keywords: | Clinical and Etiological profile, Epilepsy, Tertiary Care Hospital. |
| Subjects: | MEDICAL > Neurology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 30 Jun 2017 03:08 |
| Last Modified: | 13 Feb 2020 02:23 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/683 |
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