Etiology, Clinical Profile, and Outcome of Unprovoked Seizure in Children: A Prospective Observational Study from Eastern India

Abstract

Abstract Background: Unprovoked seizures in children refer to seizures that occur without an immediate precipitating factor, such as fever, infection, or head injury. These seizures are often a manifestation of an underlying neurological condition and can be indicative of epilepsy if recurrent. Understanding the causes, diagnosis, and treatment options for unprovoked seizures in children is crucial for proper management and care. Materials and Methods: This prospective observational study was carried out in the pediatrics department of a tertiary care teaching hospital over a period of 2 years. A total of 85 children aged <14 years were included in this study. All the data related to demography, clinical and laboratory parameters, and treatment outcomes were recorded. Descriptive statistics were used to analyze and report the data. Results: In the present study, 5-10 year age group constituted the majority with male dominance. Generalized seizure was the most common type. The complex partial seizure was common in the remote symptomatic group than in the idiopathic seizure (IS) group. History of febrile seizure was present in <10% of cases. Around 16.5% of cases had developmental delay or mental retardation. Status epilepticus at presentation was seen in 36.37% of cases, and 37.65% were newly diagnosed epilepsy. Neurocysticercosis alone accounted for 14.12% of all cases and euro-tuberculosis alone accounted for 12.94% of all cases of unprovoked seizure. Seizure recurrence was common in the idiopathic group, complex partial seizure type, and those not taking an antiseizure medication (ASM). Conclusions: Unprovoked seizure is a common problem in children. IS/cryptogenic seizure is more common than remote symptomatic etiologies. Electroencephalogram and neuroimaging should be done in all cases. Seizure recurrence was common in the idiopathic group, complex partial seizure type, and those not taking an ASM.