The Pattern of Pediatric Seizures at Al-Arish Central Hospital - North Sinai

A seizure or convulsion is a paroxysmal, time-limited change in motor activity and/or behavior that results from abnormal electrical activity in the brain .

The International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) have come to consensus definitions for the terms epileptic seizure and epilepsy, An epileptic seizure is a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain but epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiologic, cognitive, psychological, and social consequences of this condition.

Approximately 4-10% of children experience at least one seizure (febrile or a febrile) in the 1st 16 yr of life, the cumulative lifetime incidence of epilepsy is 3%, and more than half of the cases start in childhood.

Seizure disorder is a general term that is usually used to include any of several disorders, including epilepsy, febrile seizures, and possibly single seizures and symptomatic seizures secondary to metabolic, infectious, or other etiologies (e.g., hypocalcaemia,meningitis).

In the International League Against Epilepsy (ILAE) classification of etiology of epilepsy, idiopathic epilepsy which occur without organic cause, and symptomatic epilepsy that associated with underlying brain disorder that may or may not be genetic .

The definition of epilepsy requires the occurrence of 2 or more unprovoked seizures occur in a time frame of longer than 24 hr .

There are 2 main types of seizures: generalized and focal, focal seizures are those arising within networks of a single cerebral hemisphere and may remain localized or subsequently become more widely distributed.

Generalized seizures rapidly affect both hemispheres as well as both sides of the body even when caused by a "focal" lesion.

Focal (formerly known as partial) seizures are subdivided into simple partial seizures which is refers to focal seizures with no alteration in consciousness and complex partial seizures associated with altered awareness of the surroundings.

Generalized seizures are further subdivided to tonic (sustained contraction), clonic (rhythmic contractions), myoclonic (rapid shock-like contractions, usually<50 msec in duration, that may be isolated or may repeat but usually are not rhythmic), atonic, or astatic (cause avery momentary loss of tone with sudden fall ) Absence seizures (generalized seizures consisting of staring, unresponsiveness, and eye flutter lasting usually for few seconds).

Seizures triggered by fever, defined as febrile seizures, have been for decades a major issue for children in developed countries Epidemiologic studies have led to the division of febrile seizures into 3 groups, as follows:

• Simple febrile seizures
• Complex febrile seizures
• Symptomatic febrile seizures In Simple febrile seizure is single generalized seizure and lasts less than 15 minutes, The child is otherwise neurologically healthy and without neurologic abnormality by examination or by developmental history and not caused by meningitis, encephalitis, or any other illness affecting the brain .

Complex febrile seizure: This seizure is either focal or prolonged (ie, >15 min), or multiple seizures occur in close succession.

Symptomatic febrile seizure: The child has a preexisting neurologic abnormality or acute illness.

Although the outlook for most children with symptomatic seizures or those associated with epilepsy is generally good, seizures may signal a potentially serious underlying systemic or central nervous system (CNS) disorder that requires thorough investigation and management.

Children may have behaviors that are easily mistaken for epileptic Seizures but are not , these include breath-holding spells ,bed wetting ,night terrors ,tics.

Gastroesophageal reflux may cause arching of the back and twisting of the head to the side in infants, which may be mistaken for tonic-clonic seizures, misdiagnosis is frequent (occurring in about 5 to 30% of cases) .

Descriptive epidemiology of pediatric seizures is important for:

First, knowledge of health care utilization is essential for planning and management.

This study will be carried to:

1. Describe the pattern of seizures among cases admitted to Pediatric department at Al-Arish central hospital in North Sinai and compare results with national and international similar studies .
2. Provide the basic descriptive information that is necessary for planning future studies.