Abstracts

RATIONALE: To classify seizures in children of Railway employees presented at Northern Railway Central Hospital New Delhi ,to record history of febrile seizure and ocurrence of seizures in familly members of the proband.
METHODS: All the Epileptic children presented at NRCH a refferal hospital of Indian Railways at New Delhi were first classified as per seizure types and after investigations reclassified as per Syndromic classification of ILAE-89.
All information regarding- investigations results, history of febrile seizure and family history of seizure in the probands upto 2nd degree relatives was recorded.Anti Epileptic drugs respones was recorded in the form of seizure control.All the information was recorded on a pre structured performa.
RESULTS: Total epilepsy cases of children attended at NRCH-286 in one year period.
Female cases-118
Male cases-168
Classification: seizure type-
1.Focal/Partial/Sec generalisation---096
2.Generalised tonic or clonic or tonic clonic--142
3.juvenile Myoclonic--010
4.Absence epilepsy-020
5.West Syndrome-004
6.Single Sz.--005
7.Febrile seizure--009
AntiEpileptics used:
Sodium Valproate-34
Clobazam-9
DPH-23
Carbamezepine-200
Combinatio-20
Total CT done-168
Normal-58
Abnormal-110
Total MRI done-10
Normal-3
Abnormal-7
Percentage of epileptic cases in total pediatric patients at NRCH-4.57%
Age wise distribution of patients:
0-5 yrs-72
6-10 yrs-131
11-16 yrs-83
Syndromic classification after investigations:
1. Localisation related epilepsies and syndromes-107
2.Generalised epilepsies and syndromes-120
3.Epilepsies and syndromes undetermined-17
4. Special syndromes--Febrile seizures-,single Sz., Situational seizures etc-12
Small Ring Enhancing lesion -30
Percentage of febrile seizures in total epileptic cases-5.24%
Percentage of Cases where family history was positive in the family of proband---20%.
CONCLUSIONS: The syndromic classification is useful for
1-Judiciuos use of Anti Epileptic Drugs
- When to start Anti Epileptic Drug
-When to withhold Anti epileptic Drug
-When to withdraw Anti Epileptic Drug
2- To predict prognosis
3.Defining the likelihood of underlying pathology
The febrile seizure was present in 5.24 % of cases. So Febrile seizure is not a major risk factor for epilepsy in subsequent years of life.
The family history was positve in 20 % of cases up to second degree relatives.Positive family history is a significant risk for epilepsy in the children of epileptic parents.
In Age wise distribution the %age of epileptic children is more in age group of 6 to 10 years in our study because in Railways the railway population is inhabitated in linear fashion on the sides of track and younger age group like neonates are less in the study..As mothers do not come for confinement from far off places to this refferal railway hospital .They prefer delivery in hospitals near their homes. So neonatal period and young infants are less there in the study. This is giving different age prevelance than other studies .Where seizure is more on 0-1 year of age.
[Supported by: Nill
No financial support from any organisation
Indian Railways where study has been done, provide total free healthcare to its empolyees and their family members through Indian Railway Health Service.]