A clinical and etiological study of late onset seizures – a cross sectional study at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre

Abstract

Background and Objectives ABSTRACT Patients who have experienced a seizure or have been suffering from epilepsy form a big chunk of neuromedical practice. Seizure activity can have various manifestations ranging from dramatic convulsive activity to experimental phenomenon not readily discernable by an observer. Detailed work up is generally required for total evaluation of such cases and treatment. The objective of the present study was to determine various clinical presentations and etiological factors of late onset seizures. Methods The present cross-sectional study was conducted in Department of Medicine, at KLES Dr Prabhakar Kore Hospital and Medical Research Centre, Belgaum during January 2007 to December 2007 on 40 patients above 35 years presenting with seizures for the first time. Detailed history, clinical examination, blood investigations, EEG and cranial imaging were performed. Other investigations like serological tests, LP CSF study, ECG, Chest X-Ray and Echocardiography as necessary were performed Results Majority of patients presenting with seizures who had focal neurodeficits had organic lesion in the brain. Abnormal EEG helped to confirm the diagnosis of seizures and when it showed focal abnormalities gave a clue to underlying structural abnormality. Overall cranial imaging was abnormal in 72.5% of patients, 62.5% of generalized seizure group and 87.5% of partial seizure group VIII patients. The commonest etiology of seizure in the age group between 35 to 54 years was idiopathic and after the age of 55 years commonest etiology was cerebral infarct. Conclusion and interpretation Majority of patients presenting with seizures who had focal neurodeficits had organic lesion in the brain. EEG was not very useful in evaluation of seizures. However abnormal EEG helped to confirm the diagnosis of seizures. Proportion of patients with idiopathic etiology was higher in generalized seizure group as compared to partial seizure group and proportion of patients with structural brain lesion was higher in partial seizure group.