Common causes of seizures in children presenting in paediatric medical emergency

Aim and Objective: To determine the underlying cause of seizures in children who presented in emergency department of a tertiary care centre. Patients and Methods: It was a prospective observational study conducted in medical emergency of the Children's hospital and the Institute of Child Health Lahore from May 2007 to October 2007. Total of 110 patients age between 1 month to 15 years were enrolled in the study. A predesigned proforma was filled for each patient, which included history, examination and investigations. Treatment was given in the form of anticonvulsants, antipyretics and according to the underlying disease. Results: Among 110 patients, there were 60% male and 40% female. Regarding age distribution, 75 % were between 1 month - 5 years and 25% were more than 5 years. There was history of fever and fits in 90 patients (82%) while rest of 20 patients (18%) presented with afebrile fits. The most common causes of seizures were CNS infections (39%), febrile seizures (23%) and metabolic seizures (18%).Other causes of seizures were cerebral palsy (9%),idiopathic epilepsy(7%), neurodegenerative disorders(1%), haemorrhagic disease of new born with intracranial haemorrhage (2%) and haemophilia with intracranial haemorrhage (1%). Conclusion: Among children who present with seizures in emergency, CNS infections were the commonest cause and acute bacterial meningitis has the highest percentage which is the most severe infectious disease causing neurological sequelae. It is always important to differentiate benign causes from serious etiologies to implement timely appropriate treatment and to avoid neurological sequelae. Also experienced paediatric staff should be available to assist emergency department.