Department of Pediatrics, Lok Nayak Hospital and Maulana Azad Medical College (University of Delhi), 2, Bahadur Shah Zafar Marg, New Delhi, 110 002, India.
Indian J Pediatr. 2019 Aug;86(8):681-685. doi: 10.1007/s12098-019-02943-2. Epub 2019 Apr 12.
To study the clinico-etiological profile of epilepsy in children aged 1-24 mo attending a tertiary-care public hospital.
All infants aged 1-24 mo with epilepsy (as per International League Against Epilepsy, 2014) presenting between April 2016 and March 2017 were enrolled. Detailed history and examination were done in all children, and developmental assessment was done using Developmental Assessment Scale for Indian Infants (DASII). Electroencephalography and neuroimaging (CT/MRI) were done for all subjects.
Sixty children (39 males) were consecutively enrolled after informed written consent. The mean (SD) age at seizure onset was 4.3 (4.14) mo. Perinatal asphyxia (45%) and malformations of cortical development (18.3%) were the commonest etiologies. Neurological examination was abnormal in 68.3%, and a neuroimaging abnormality was present in 76% of children. Fifteen patients (25%) had West syndrome, which was symptomatic in the majority (73.3%). Developmental delay (DQ < 70) was the commonest co-morbidity (81.7%); 28.3% had profound delay. Odds of having developmental delay were 13-times higher in those with an abnormal neurological examination [OR 13.5 (2.82-64.67), P = 0.001], and nearly 9-times higher with abnormal neuroimaging [OR 8.9 (2.11-37.9), P = 0.003].
Epilepsy in children <2 y is symptomatic in the majority, with sequelae of birth asphyxia as the commonest etiology. High prevalence of co-morbid developmental delay underscores the need for routine evaluation and early intervention in all high-risk infants.
研究在一家三级公立医院就诊的 1-24 个月龄儿童癫痫的临床病因学特征。
纳入 2016 年 4 月至 2017 年 3 月期间所有符合国际抗癫痫联盟 2014 年标准的 1-24 月龄癫痫患儿。对所有患儿进行详细的病史和体格检查，采用印度婴幼儿发育评估量表（DASII）进行发育评估。所有患儿均行脑电图和神经影像学（CT/MRI）检查。
在获得知情书面同意后，连续纳入 60 例（39 例男性）患儿。发作起始的平均（SD）年龄为 4.3（4.14）月龄。围生期窒息（45%）和皮质发育畸形（18.3%）是最常见的病因。68.3%的患儿神经系统检查异常，76%的患儿存在神经影像学异常。15 例（25%）患儿患有 West 综合征，其中多数（73.3%）为症状性。发育迟缓（DQ<70）是最常见的合并症（81.7%）；28.3%患儿存在严重发育迟缓。神经系统检查异常患儿发生发育迟缓的几率高 13 倍[比值比（OR）13.5（2.82-64.67），P=0.001]，神经影像学异常患儿发生发育迟缓的几率高 8.9 倍[OR 8.9（2.11-37.9），P=0.003]。
2 岁以下儿童癫痫多为症状性，以出生窒息为最常见病因，常遗留后遗症。合并症中发育迟缓的高患病率强调了对所有高危婴儿进行常规评估和早期干预的必要性。
