ICNC Abstracts, ICNC 2018

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Semiological, Diagnostic and theraupetic challenges in Infantile onset epilepsy
Smilu mohanlal, Lokesh lingappa, Ramesh Konanki, Nikit Shah, Srikanth Domala, Prasanthi Aripirala, Ravi verma

Last modified: 2018-09-09

Abstract


Introduction: The incidence of epilepsy in the infantile age group (2 months to 2 years) is the highest of all age groups. Sparse prospective data is available.

 

Methodology: Prospective study of children with infantile onset epilepsy from the year January 2016- may 2018. Exclusion: infantile spasms as presenting seizure, neonatal onset epileptic encephalopathy. They were investigated according to standardized protocol and followed up regularly. Their short term seizure control and neurodevelopmental status after 3 months were reported. Seizure control were graded as completely controlled (>90%), partially controlled (50-90%) and uncontrolled (< 50%)

 

Results: 90 children (M:F=57:33) were enrolled. 15(17%) had consanguinity, 14(16%) had perinatal complications;18(20%) had family history of seizures. 6 had neonatal seizures; 28/90 (31%) focal onset,23/90 (26%) unknown onset, 14/90 (15%)unclassified, 15/90(17%)  generalised onset, 10/90(11%) combined onset seizures  at  presentation. 16(18%) had status epilepticus. 30(33%) had daily seizures. 48(53%)were on 1 antiepileptic drug,32(35%) on 2 , 10(12%) on 3 drugs at the time of enrolment.MRI abnormalities were seen in 28(31%), Epileptiform discharges noted in 17(19%). 21(23%) had structural, 2(2%) genetic, 5(5%) metabolic and 62(68%) unknown as etiology for epilepsy. On follow up treatment response were 43 (48%) completely controlled, 34(38%) partially controlled, 13(14%) uncontrolled. 2(2%) developed spasms. 23(25%) required more than 2 drug to control seizures.

Conclusion: In children with infantile onset epilepsy, semiologic classification using ILAE 2017 is challenging. Their etiology could be determined only in 30%. Nearly 50% had complete seizure control.


Keywords


seizures;infantile epilepsy

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