Publication:

Etiological profile of adult onset seizures: a hospital based prospective study from Kashmir, India

Background Adult onset seizure (AOS) is considered the epilepsy that start after the age of 18 years. It is a common neurological disorder with multiple etiologies. Objective was to study the etiologies, diagnosis and treatment of AOS in Kashmiri population and to compare its different clinical and etiological profiles in different age groups.

Methods All patients who developed seizure after the age of 18 years were recruited in the current prospective study. In total 144 subjects with AOS were included in this study. The study was done in the Neurology unit of Sher-i-Kashmir Institute of Medical Science, Srinagar- a tertiary care hospital in Kashmir, India from August 2014 to July 2016.

Results Among the 144 recruited subjects, the 25-34 years age group was more susceptible to onset seizures. Generalized tonic-clonic seizure with a percentage of 48.8% was the most common seizure type among the studied subjects. Gender wise males were more susceptible to intracerebral hemorrhage while as cerebral venous sinus thrombosis is more common among females. Among the infection group, encephalitis was a leading causal factor in 10 (6.9%) patients and age wise younger population is more susceptible to encephalitis and central nervous system, while prion disease was more frequent in subjects with age of ≥55. On comparing various cerebrovascular diseases and seizures, ICH was responsible in most number of subjects (12.5%). MRI and EEG (59.7% and 52.8% respectively) findings were abnormal in maximum number of subjects and both findings showed statistically a significant positive correlation (r=0.73; p=<0.01).

Conclusions Idiopathic factors are the main cause of AOS with EEG and MRI being the mainstay for identifying, classifying and localizing seizures among the study patients.