A Clinical Study on the Etiologies of Acute Seizures in Children Who Visited Emergency Department

Cho, Jung Il; Kim, Dong Wook; Jang, Hyun Oh; Moon, Jin Soo; Nam, Seung Yeon; Lee, Chong Guk

Abstract

PURPOSE
Although it is important to know the etiologies of childhood seizures according to age, clinical studies on this topic have been few. The present study was therefore designed to investigate the causes of acute childhood seizures. We hope this study will be helpful in the diagnosis and management of children with seizures.
METHODS
This study was retrospectively undertaken to evaluate the age and sex distribution, the clinical seizure types, the seizure causes, and especially the frequencies of age-related seizure causes of 922 cases under 18 years of age, who visited Emergency Departments due to seizures from December, 1999 to January, 2004.
RESULTS
The male to female ratio was 1.5 : 1 and the age range was from 1 day to 16 years, 2 months. There were 683 cases(74.1%) with generalized seizures, 61(6.6%) with partial seizures, and 178(19.3%) with unknown clinical seizure types. The causes of seizures were listed as follows : febrile convulsions in 545 cases(59.1%); epilepsies in 229(24.8%); benign convulsions with mild gastroenteritis in 19(1.6%); acute central nervous system infections in 15(1.6%); and metabolic derangements in six(0.7%). Finally, the frequencies of age-related seizure causes were analyzed. Out of 751 cases between 6 months and 5 years of age, 532 cases(70.8%) were febrile convulsions, 122(16.2%) epilepsies, 19(2.5%) benign convulsions with mild gastroenteritis, and 11(1.5%) acute CNS infections. Out of 145 cases among those over 5 years of age, 104 cases(71.7%) were epilepsies, 10(6.9%) febrile convulsions, and three(2.1%) acute CNS infections.
CONCLUSION
The above results reveal that the causes of acute childhood seizures in the different age groups are different, and also suggest that febrile convulsion is the most common seizure cause between 6 months and 5 years of age, and epilepsy in more than 5 years of age. We hope that further clinical and epidermiologic studies on this topic will be performed.