Affiliations: Department of Pediatric Neurology, Indira Gandhi
Institute of Child Health, Bangalore, India | Department of Pediatrics, Indira Gandhi Institute of
Child Health, Bangalore, India | Department of Radiology, Indira Gandhi Institute of
Child Health, Bangalore, India
Note: [] orrespondence: Dr. Vykuntaraju K.N. Gowda, Bangalore Child
Neurology and Rehabilitation Center, HANS Complex, 8/A 1st Main 1st Cross,
Manuvana, Near Adhichunchanagiri Choultry, Vijayanagar, Bangalore, 560040,
India. Tel.: +80 23301212, +91 9535212556; Fax: +80 26541799; E-mail:
drknvraju@hotmail.com
Abstract: Objective is to evaluate the etiology of focal seizures at a
tertiary care center in Indian children. Design is a cross sectional study.
Setting is outpatient and inpatient of a tertiary care teaching children
hospital in South India. A total of 150 consecutive children aged 1 mo to 18 yr
presenting with focal seizures defined as per international league against
epilepsy classification, participated in this study. A detailed history was
taken and clinical examination was done was along with the investigation for
the etiology of focal seizures with routine and specific tests, computerized
tomography (CT) scan and/or magnetic resonance imaging (MRI) and
electroencephalography (EEG). All of the findings were recorded in a
pre-designed pro forma and results were analyzed. The mean age presentation was
6.5 yr. Male preponderance was noticed with a ratio of 1.2:1. Complex partial
seizures were the most common (68%) type of focal seizures. Neurologic deficits
were noticed in 36 (24%) patients; most common form was hemiparesis. CT scan
abnormalities were noted in 76% of the patients, most common CT finding was
inflammatory granuloma. In four cases, where CT scan was inconclusive of
neurocysticercosis (NCC) versus tuberculoma, MRI showed features of
tuberculoma. The most common etiology of focal seizures was inflammatory
granulomas; NCC (69%) and tuberculoma (15%), followed by perinatal insult (8%)
and stroke (7.3%). EEG was diagnostic in cases of Rolandic epilepsy in seven
(4.6%) cases. CT brain is a valuable tool in identifying the underlying
etiology of focal seizures. MRI is helpful in cases of diagnostic dilemma
between NCC and tuberculoma by CT scan. EEG is diagnostic of benign Rolandic
epilepsy.
Keywords: CT, MRI, EEG, focal seizures, infections, India
