Shah Madhu, Poudel Saurav, Parajuli Bivusha, Kc Niranjan, Kc Rumi
Nobel Medical College Teaching Hospital, Biratnagar, Morang, Nepal.
Nepal Medical College Teaching Hospital, Jorpati, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2024 Mar 31;62(272):232-237. doi: 10.31729/jnma.8535.
Seizures are the most common neurological emergency and one of the most common reasons for paediatrics hospital admissions. This study aimed to identify the etiology, clinical profile, and immediate outcome of children with the first episode of seizure in Eastern Nepal.
This was a prospective descriptive study carried out in the Tertiary Care Centre from September 2022 to August 2023. Ethical clearance was taken from the Institutional Review Committee (Ref no:654/2022). Convenience sampling was done to include 170 children presenting with the first episode of seizure at age 6 months to 15 years. Variables collected were demographics, clinical presentations, family history, trauma history, laboratory tests, neuroimaging, EEG, final diagnosis, and immediate outcome.
A total of 170 patients were admitted with the first episode of seizure with 123 (72.36%) males and 47 (27.64%) females. The mean age of the patients was 5.13±2.95 years with 104 (61.18%) patients under 5 years of age. The most common seizure was generalized tonic-clonic type in 132 (77.64%) patients. The most common associated symptom was fever in 150 (88.23%) children. Neuroimaging was abnormal in 52 (30.59%) patients, with neurocysticercosis seen in 27 (15.88%). The most common etiology was febrile seizure in 92 (54.17%) patients, neurocysticercosis in 27 (15.88%), and meningitis in 12 (7.05%).
Febrile seizures, neurocysticercosis, infection, and trauma were the major causes of seizures in children. When simple febrile seizures were unlikely, lumbar puncture, neuroimaging, and laboratory tests were useful tools for diagnosing etiologies of seizures.
癫痫发作是最常见的神经系统急症，也是儿科住院最常见的原因之一。本研究旨在确定尼泊尔东部首次癫痫发作儿童的病因、临床特征及近期转归。
这是一项于2022年9月至2023年8月在三级医疗中心开展的前瞻性描述性研究。已获得机构审查委员会的伦理批准（参考编号：654/2022）。采用方便抽样法纳入170例年龄在6个月至15岁之间首次癫痫发作的儿童。收集的变量包括人口统计学资料、临床表现、家族史、外伤史、实验室检查、神经影像学检查、脑电图、最终诊断及近期转归。
共有170例首次癫痫发作患者入院，其中男性123例（72.36%），女性47例（27.64%）。患者平均年龄为5.13±2.95岁，104例（61.18%）患者年龄在5岁以下。最常见的癫痫发作类型为全身强直阵挛发作，共132例（77.64%）。最常见的伴随症状为发热，共150例（88.23%）儿童。52例（30.59%）患者神经影像学检查异常，其中27例（15.88%）为神经囊尾蚴病。最常见的病因是热性惊厥，共92例（54.17%）；神经囊尾蚴病，共27例（15.88%）；脑膜炎，共12例（7.05%）。
热性惊厥、神经囊尾蚴病、感染和外伤是儿童癫痫发作的主要原因。当不太可能是单纯热性惊厥时，腰椎穿刺检查、神经影像学检查和实验室检查是诊断癫痫发作病因的有用手段。
