Clinico-Etiological Profile of New Onset Seizures in Adults in Southern Odisha - An Observational Study

BACKGROUND Population based studies indicate that the incidence and prevalence of seizure disorders in adults increase with age, especially in elderly, after the age of 60 years. The underlying etiological spectrum is variable across geographies. Analysis of aetiology of seizure is essential for proper treatment to reduce the morbidity and mortality associated with it. The present study was planned to analyse the aetiology of new onset seizures in adult population (> 18 years of age). METHODS The cross sectional study was carried out in the Department of Medicine of MKCG Medical College & Hospital for a period of two years. 100 consecutive cases of new onset seizures admitted in the in-patient department (indoor / ward) were included in the study as per the inclusion and exclusion criteria. The data was collected by the investigators in a pre-tested Case Record Form. Data analysis was done using Microsoft Excel and GraphPad Prism trial version 7.0. Descriptive statistics were presented as proportions for discrete variables and as mean ± SD for continuous variables. P value of ≤ 0.05 was taken as statistically significant. RESULTS Acute symptomatic seizures accounted for 89 % of cases. Neuro-infection was the leading aetiology in 35 % of cases, followed by cerebrovascular accidents (30 %) and metabolic causes (10 %). Neurocysticercosis was seen in 11 % cases, followed by meningitis and cerebral malaria. Among the vascular causes, stroke accounted for 20 %. Prevalence of neuro-infection was highest in the age group of 15 - 35 years. 89 % of idiopathic seizures were generalized tonic-clonic seizure (GTCS). The prevalence of status epilepticus was 8 %. CONCLUSIONS Adult onset seizures have a varied spectrum of aetiology. With a thorough history, clinical examination and appropriate investigations, the aetiology can be identified. Accordingly, treatment can be instituted thus reducing the morbidity and mortality associated with it. KEYWORDS Aetiology, New Seizures, Stroke, Vascular, Neuro-Infection