Demographic Criteria and Causes of Convulsive Disorders in Children below 5 Years of Age Admitted to Al-Elwia Pediatric Hospital, Baghdad

Abstract

AbstractBackground: Acute seizures are common pediatric admissions to hospitals and a risk factor for neurological and cognitive impairment and epilepsy.Aim of the study: To determine the clinical criteria of convulsive disorders in children below 5 years of age with regards to the etiology, age of onset and risk factors for the development of seizure.Methods: A cross sectional study done on 285 patients with convulsive disorders admitted to Al-Elwia pediatric hospital from the first of December 2009 to the 30th of November 2010.Children more than 1 month – 5 years included in the study (the neonates were excluded).History was taken from the family regarding the age of onset of first seizure, recurrence, developmental delay and positive family history of seizure. Examination was done on all patients to document fever, signs of meningeal irritation, and for presence of dysmorphic features. Investigations were sent in the form of complete blood count, lumbar puncture, blood glucose, serum calcium, serum magnesium and electrolytes in those patients suspected of having acute symptomatic seizure. Electroencephalography was done to diagnose type of seizure along with the clinical manifestations. Imaging studies as computerized tomography were done for selected cases.Results: of 285 children presented with convulsion, 155 had febrile seizure, 69 with epilepsy, 61 had acute symptomatic seizure male to female ratio was 1.4:1. The peak age of onset among patients with febrile seizures was in the second year of life, while that for epilepsy and acute symptomatic seizures was in the first year of life. There was a history of prematurity in 10% of cases. There is positive family history of febrile seizure in 20% of cases and of epilepsy in 11% of cases. Twenty six patients had cerebral palsy and 23 patients had status epilepticus.Conclusion: In this study we find a higher frequency of febrile seizures than epilepsy and acute symptomatic seizures. The frequency of epileptic and acute symptomatic seizures was greatest in the first year of life, while that of febrile convulsion peaked in the second year.