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January2009 Vol.46 Issue:        1        Table of Contents
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Infantile and Childhood Epilepsies in Middle Delta: Types, Risk Factors and Etiology

Mohamed Y. El-Senousey1, Wael F. El-Beshlawy1, Ehab El-Seidy1,

Hazem Fayed1, Mohamed H. El-Shafey2

 

Departments of Neuropsychiatry1, Radiology2, Tanta University

 



ABSTRACT

Background and Purpose: Types, Risks and etiology of epilepsies among children are widely different from those among adults. This study was carried out to highlight types,  risks, etiology of  different epilepsies among infants and children in Tanta city and its surrounding rural areas. Moreover, different EEG and MRI abnormalities among studied patients were recorded  to be correlated with clinical data. Patients and Methods: Two hundred eighty epileptic infants and children were subjected to: 1- thorough history taking and clinical neurological examination, 2- neuroimaging by brain MRI, 3- EEG recording and video EEG in some cases. According to the etiology of epilepsy, patients were categorized into two groups: group I (idiopathic epileptic patients); group II (symptomatic- cryptogenic epileptic patients). Moreover, patients were divided into three groups according to the age of epilepsy onset; infantile group (before one year), early childhood group (between one and twelve years) and late childhood group (between twelve and eighteen years). Results: Most of the patients belonging to group II had a home delivery (53.96%) and instrumented labor(31.75%) and significantly higher incidence of perinatal insults (59.52%) compared to those in group I in whom perinatal insults occurred in 7.14%. EEG abnormalities were recorded in 88.1%  and brain MRI abnormalities in 92% of group II patients which were significantly higher compared to those  in group I in whom no MRI abnormalities were recorded  and EEG abnormalities were detected in 73.3%. No significant difference regarding incidence of epileptic  types was detected between group I and group II. On stratification of  the patients according to the age of epilepsy onset; parental consanguinity and family history of epilepsy were significantly higher in the late childhood group (39.62%) compared to the infantile and early childhood groups (18.18% and 26.85% respectively) whereas perinatal insults were significantly higher in the infantile age group (90.9%) compared to that of early childhood (29.16%) and late childhood (3.77%). Conclusion: This study showed that symptomatic epilepsy was prominent among infantile age group (73%) and early childhood group (41.2%) and this reflect the role of perinatal insults for developing symptomatic epilepsy in these age group while idiopathic epilepsy was prominent among late childhood epilepsy group (60%) and this reflect  the role  of genetic factor among this group. Recommendations: From this study it is recommended  that  paying more attention to the importance of premarietal counseling in familial marriage, especially with positive family history of epilepsy, and hospital delivery under supervision of skilled medical personnel might offer a good chance to reduce epilepsy incidence in the paediatric age group. (Egypt J. Neurol. Psychiat. Neurosurg., 2009, 46(1): 151-160)

 

Correspondence to Mohamed El-Senousey,  e-mail: senousey@yahoo.com. Contact number: +20105104857





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