Profile of children with seizures in a tertiary care hospital at VCSGGIMS and R Srinagar Pauri, Gharwal, Uttarakhand, India


  • Rohit Chib Department of Paediatrics, VCSGGIMS and R Srinagar Pauri, Gharwal, Uttarakhand, India
  • Manju Devi Department of Paediatrics, VCSGGIMS and R Srinagar Pauri, Gharwal, Uttarakhand, India



Generalized tonic-clonic seizure, Neurocysticercosis, Seizures


Background: Seizure is one of the common causes of childhood hospitalization with significant mortality and morbidity. Current study is to find the etiology of seizure and classify seizure into various types and age groups presenting to tertiary center in Department of pediatrics VCSGGIMS and R Srinagar Pauri, Gharwal, Uttrakhand, India.

Methods: This was a hospital based prospective study carried out from 1st Jan. 2014 to 31st Dec 2014. Variables collected were demographics, clinical presentations, laboratory tests, brain imaging studies, electroencephalography, diagnosis and hospital course.

Results: A total of 276 patients were admitted for seizures with 172 (62.3%) males and 104 (37.7%) females. Among these patients, 148 (53.5%) presented with fever and 157 (56.8%) of children were less than 5 years of age. Generalized tonic-clonic seizure was the most common seizure type (69.2%) followed by partial (19.2%), absence (2.8%), myoclonus (1.6%) and others (6.9%). Seizure disorder (33.7%), febrile seizures (30%), CNS infections (meningitis 6.1%, encephalitis 6.5% and Tubercular meningitis 1.8%) and neurocysticercosis were other common etiologies. Abnormal brain images were noted in 55 (45.45%) out of 121 patients and most common abnormality was neurocysticercosis 33(12%).

Conclusions: Acute episode of seizure is one of the causes for hospitalization. It can be concluded from present study that most of seizures caused by febrile seizures and CNS infections (meningitis and encephalitis, neurocysticercosis) can be managed better with prompt interventions. Children presenting with unprovoked seizure need prolonged follow up with neurophysiologic studies and neuroimaging (CT or MRI) for better understanding of childhood seizure.


Nelson KB. Ellenberg JH. In: Febrile Seizures. Nelson KBEJH, ed. New York, Raven Press; 1981.

adleir LG, Scheffer IE. Febrile seizures. BMJ. 2007; 334:307-11.

Huang CC, Chang YC, Wang ST. Acute symptomatic seizure disorders in young children-a population study in southern Taiwan. Epilepsia. 1998;39:960-4.

Hauser WA. The prevalence and incidence of convulsive disorders in children. Epilepsia. 1994;35(Suppl 2):S1-6.

Verity CM, Greenwood R, Golding J. Long-term intellectual and behavioral outcomes of children with febrile convulsions. N Engl J Med. 1998;338:1723-8.

Akpede GO, Abiodun PO, Sykes RM. Pattern of infections in children under-six years old presenting with convulsions associated with fever of acute onset in a children's emergency room in Benin City, Nigeria. J Trop Pediatr. 1993;39:11-5.

Birbeck GL. Seizures in rural Zambia. Epilepsia. 2000;41:277-81.

Waruiru CM, Newton CR, Forster D, New L, Winstanley P, Mwangi I, et al. Epileptic seizures and malaria in Kenyan children. Trans R Soc Trop Med Hyg. 1996;90:152-5.

Iloeje SO. Febrile convulsions in a rural and an urban population. East Afr Med J. 1991;68:43-51.

Owusu-Ofori A, Agbenyega T, Ansong D, Scheld WM. Routine lumbar puncture in children with febrile seizures in Ghana: should it continue? Int J Infect Dis. 2004;8:353-61.

Iloeje SO. Paediatric neurologic emergencies at the University of Nigeria Teaching Hospital, Enugu. West Afr J Med. 1997;16:80-4.

Carter JA, Mung'ala-Odera V, Neville BG, Murira G, Mturi N, Musumba C, et al. Persistent neurocognitive impairments associated with severe falciparum malaria in Kenyan children. J Neurol Neurosurg Psychiatry. 2005;76:476-81.

Boivin MJ, Bangirana P, Byarugaba J, Opoka RO, Idro R, Jurek AM, et al. Cognitive impairment after cerebral malaria in children: a prospective study. Pediatr. 2007;119:e360-6.

Annegers JF, Hauser WA, Elveback LR, Kurland LT. The risk of epilepsy following febrile convulsions. Neurol. 1979;29:297-303.

Carter JA, Neville BG, White S, Ross AJ, Otieno G, Mturi N, et al. Increased prevalence of epilepsy associated with severe falciparum malaria in children. Epilepsia. 2004;45:978-81.

Ngoungou EB, Dulac O, Poudiougou B, Druet-Cabanac M, Dicko A, Mamadou Traore A, et al. Epilepsy as a consequence of cerebral malaria in area in which malaria is endemic in Mali, West Africa. Epilepsia. 2006;47:873-9.

Ngoungou EB, Koko J, Druet-Cabanac M, Assengone-Zeh-Nguema Y, Launay MN, Engohang E, et al. Cerebral malaria and sequelar epilepsy: first matched case-control study in Gabon. Epilepsia. 2006;47:2147-53.

Friedman MJ, Sharieff GQ. Seizures in children. Pediat Clin North Am. 2006;13:257-77.

Martindale JL, Goldstein JN, Pallin DJ. Emergency department seizure epidemiology. Emerg Med Clin North Am. 2011;13(1):15-27.

Idro R, Gwer S, Kahindi M. The incidence, aetiology and outcome of acute seizures in children admitted to a rural Kenyan district hospital. BMC Pediatr. 2008;13:5.

Chen CY, Chang YJ, Wu HP. New-onset seizures in pediatric emergency. Pediatr Neonatol. 2010;13(2):103-11.

Murthy JMK, Yangala R. Acute symptomatic seizures-incidence and etiological spectrum: a hospital-based study from South India. Seizure. 1999;13:162-5.

Basu S, Ramchandran U, Thapliyal A. Clinical profile and outcome of pediatric neuro-cysticercosis: A study from Western Nepal. J Pediatr Neurol. 2007;13:45-52.

Rayamajhi A, Singh R, Prasad R, Khanal B, Singhi S. Study of Japanese encephalitis and other viral encephalitis in Nepali children. Pediatr Int. 2007;13(6):978-84.

Allen Hauser W, Beghi E. First seizure definitions and worldwide incidence and mortality. Epilepsia. 2008;13(Suppl 1):8-12.

Goldstein JL. Evaluating new onset of seizures in children. Pediatr Ann. 2004;33(6):368-74.

Bautovich T, Numa A. Role of head computed tomography in the evaluation of children admitted to the paediatric intensive care unit with new-onset seizure. Emerg Med Australas. 2012;24(3):313-20.

Commission on Epidemiology and Prognosis: International League Against Epilepsy. Guideline for epidemiologic studies on epilepsy. Epilepsia. 1993;34:592-6.

Prober CG, Dyner LL. Central nervous system infections. In: Nelson Textbook of Pediatrics; 19th ed; chapter 603.1. 2940.

Academy of Pediatrics. Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures: Practice parameter: the neuro diagnostic evaluation of the child with a first simple febrile seizure. Pediatrics. 1996;97:769-72.

Santos MI, Nzwalo H, Monteiro JP, Fonseca MJ. Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis. Acta Med Port. 2012;25(4):203-6.






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