الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 77 |  |  |
| | | from | 77 | | |
Abstract
A seizure represents the uncontrollable, aberrant electrical activity in the brain that may cause the transient occurrence of signs and symptoms (change in motor activity, consciousness, memory, feelings, and/or behavior) with sudden onset and offset. Seizure etiology is a proven prognostic factor for both recurrence and outcome. The first thing is to rule out non epileptic seizures. Typically, provoked seizures have low a risk of recurrence.
The main aim of the present work is to study the magnitude of acute seizures among children presenting to the emergency department (ED) of Alexandria University Children’s Hospital (AUCH), and hence, to provide the basic descriptive data required for understanding health care utilization, planning future research and to evaluate the burden of children presenting with acute seizures to the emergency department of AUCH, to describe the sociodemographic characteristics of studied children, their clinical profile, and associated comorbidities, and to identify the underlying etiologies and outcome of acute seizures among the studied children.
In this cross-sectional study, the total number of emergency department cases presented during the duration of the study. It was 46618 cases; out of them, 150 cases presented with acute seizures (0.32%), and most of them (130 cases) were admitted to the hospital.
150 children, 84 male patients (56%) and 66 female patients (44%), and 56 patients included in the study were living in urban areas (37.3%), while 94 patients were living in rural areas (62.7%). 37 patients (24.7%) had a family history of similar conditions. (40%) had a history of developmental delay, while 48 of them (32%) had associated neurological comorbidities, the commonest comorbidity among them was cerebral palsy (40 cases, 83.3%). 28% of cases reported a history of NICU admission. 48% of cases reported having the first attack, while 52% reported that the present attack is a recurrent one.
60 cases (40%) had focal onset, and 90 cases (60%) had generalized onset, only one case presented with non-motor type and 89 cases of them presented with motor type, 67.4% of them reported tonic-clonic seizures. Among the cases presented with focal seizures, 32 cases (53.3%) had impaired awareness motor type. According to the duration of seizures among the cases included in the study, mostly 100 cases (66.7%) reported less than 30 minutes, and only 14 cases (9.3%) reported status epilepticus.
74 cases (49.3%) were diagnosed with epilepsy breakthrough, 47 cases (31.3%) were having seizures secondary to other pathologies such as CNS infection and electrolyte disturbance. 81.3% of cases were admitted to the ward, 8% of cases were referred to another hospital or department, while only 5.3% of cases were referred to the PICU and 5.3% of cases were referred to the pediatric neurology outpatient clinic.
An overuse of investigations in children with acute seizures, particularly febrile seizures and the first unprovoked ones has been reported.
An initial abnormal neurologic was the only risk factor that strongly related to acute symptomatic seizures. A seizure happening in an epilepsy child was the only risk factor that was strongly related to an unprovoked seizure.