A Study of Etiological Profile of Acute Symptomatic Seizures in Adults

Background Seizure is a paroxysmal event due to abnormal excessive or asynchronous neuronal activity in the brain. Seizures could be acute symptomatic or unprovoked. Misclassification of acute symptomatic seizure as unprovoked can frequently occur, because the age distribution and frequency of both are similar. The appropriate therapeutic management, risk of developing epilepsy, and mortality depends largely on the underlying disorder. Thus it is crucial to distinguish acute symptomatic from unprovoked seizure and identify its etiology. Methods All patients admitted to wards and presenting at casualty/opdin ESIC-MC& PGIMSR with first onset seizures were taken for study considering the inclusion and exclusion criteria. The semiology of the seizure was studied and the relevant investigations required were done. Results Of 100 patients 75 % were acute symptomatic seizures. The seizure types were GTCS in 67 % and focal seizures with and without dyscognitive features in 20 % and 13 % of the patients respectively. Among the acute symptomatic seizures cerebrovascular accident was the leading cause found in 28 % followed by metabolic in 27 %. It occurred predominantly in males with male to female ratio of 21. Most of the patients were above the age of 40 years. Neuroinfections and alcohol withdrawal stood as the 3rd and 4th common causes in the spectrum. Conclusion This study illustrates that the acute symptomatic seizures were more common in adults as compared to unprovoked seizures. Etiologies varied according to the age group. Unprovoked seizures occurred mostly in the younger age group. Cva and metabolic were predominant causes among the elderly and neuroinfections among the middle aged adults.