A clinical study on seizure disorder in intellectually disabled patients in Barak Valley, North-Eastern India

Background: Intellectual disability (ID) is a state of developmental deficit, beginning in childhood which results in significant limitation of intellect or cognition and poor adaption to the demands of everyday life. The relationship between seizure disorders and ID, and their socio-demographic correlations is a current topic of research to implement proper psychosocial interventions and to eliminate the preventable causes of ID as well as seizure disorder. Aims: To find out the prevalence of seizure disorders and their types in the intellectually disabled patients, and find out their socio-demographic correlations. Materials and methods: A cross-sectional study sample comprising of 100 intellectually disabled patients of Silchar Medical College and Hospital was taken, and the study was conducted after obtaining institutional ethical committee approval and permission from the college. Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria were used for diagnosing ID. A standardised proforma describing socio-demographic variables, Malin’s Intelligence Scale for Indian Children (MISIC) for children in age group six to 17 years, Wechsler Adult Intelligence Scale, third edition for subjects above 18 years, and the Vineland Social Maturity Scale were applied to diagnose and classify ID. International League Against Epilepsy guidelines were used to classify seizure disorder. Results: Prevalence of seizure disorder was found to be 22% among the intellectually disabled population in our sample. A significant association was found between the severity of ID and increased incidence of seizure disorder (p=0.0045). Seizure disorder was more prevalent in the low intelligence quotient (IQ) group (p=0.0067). Generalised tonic clonic seizure (GTCS) was the commonest among the types of seizure disorder (n=11, 50%). Among the GTCS cases, eight out of 11 (72.7%) were from severe/profound ID group and from an IQ range of one to 35. Conclusion: A strong association was observed in our study between seizure disorder and poor IQ group, and with increasing severity of ID (severe and profound ID). As expected, GTCS variety was found to be more strongly associated out of all types of seizures with the groups of poor IQ and severe forms of ID. In addition, we have also observed a significant association between seizure disorder, ID, and few important socio-demographic variables.