Clinicoradiological Evaluation of Newly Diagnosed Epilepsy: A Monocentric Prospective Study from a Tertiary Care Hospital of Eastern India OC05-OC09
Dr. Maheswar Samanta,
Assistant Professor, Department of Neurology, Shri Ramachandra Bhanj Medical College, Cuttack, Odisha-753007, India.
Introduction: Newly Diagnosed Epilepsy (NDE) is defined as a subset of epileptic disorders, which is presented or diagnosed first time during study period and had two or more than two episodes of seizure. Early evaluation and diagnosis of epilepsy is very important for better treatment.
Aim: To evaluate epidemiological, clinical profile as well as radiologic characteristics in cases of NDE and to find out correlation between them. Materials and Methods: It was a prospective and descriptive study of three year duration conducted in the Department of Neurology in SCB Medical College and Hospital, Cuttack, Odisha, India. A total of 300 NDE patients more than five years of age were included and subjected to detailed clinical and radiological evaluation.
Results: Majority patients in our study were from second and third decade (mean age 25 years, SD=11.04) with characteristic male preponderance. Most patients were from rural background and majority of them (60%) had attended Neurology clinic after three to 10 episodes of seizures. Seizures in awake state and seizures without precipitating factors were more common. Headache was the most common prodromal symptom. Generalised seizure dominated over focal seizure (62:34) with tonic-clonic type (66.67%) being most common in the generalised seizure cohort. Focal seizure with secondary generalisation was seen in 70.5% cases. Drowsiness (38%) and Toddâ€™s Palsy (6%) were most and least common postictal symptoms in our study. Our study also revealed abnormal Computed Tomography (CT) findings in 70.6% of focal seizures and 24.2% of generalised seizures. MRI, though done in 250 patients only, 53.6% were abnormal. Granulomatous lesion was dominant neuroimaging finding in our study.
Conclusion: This study concluded that males of second and third decade from rural background are highly prone to epilepsy. Infectious causes like Neurocysticercosis (NCC) and tuberculoma are predominant aetiologies in our area. Neuroimaging plays an important role in establishing and localising aetiology of seizure. Any patient coming with history of epilepsy must be investigated with neuroimaging for further management.