TITLE:
Epileptic Encephalopathies in Infants and Children: Study of Clinico-Electroencephalographic Spectrum in a Tertiary Hospital in Bangladesh
AUTHORS:
Bithi Debnath, Rajib Nayan Chowdhury, Narayan Chandra Shaha, Mohammad Enayet Hussain
KEYWORDS:
Epileptic Encephalopathy (EE), EEG, Infantile Epileptic Encephalopathy (IEE), Clinico-Electroencephalographic Spectrum, West Syndrome
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.11 No.3,
July
15,
2021
ABSTRACT: Background: The epileptic encephalopathies collectively exact an
immense personal, medical, and financial toll on the
affected children, their families, and the
healthcare system. Objective: This study was aimed to delineate the
clinical spectrum of patients with Epileptic encephalopathies (EEs) and
classify them under various epileptic syndromes. Methods: This was a
cross-sectional study that was carried out in the department of Neurophysiology
of the National Institute of Neurosciences and Hospital, Bangladesh from July
2016 to June 2019. Children with recurrent seizures which were difficult to control and associated with developmental arrest or
regression in absence of a progressive brain pathology were considered to be
suffering from EE. Children under 12 years of age fulfilling the inclusion
criteria were enrolled in the study. These patients were evaluated clinically
and Electroencephalography (EEG) was done in all children at presentation.
Based on the clinical profile and EEG findings the patients were categorized
under various epileptic syndromes according to International League Against
Epilepsy (ILAE) classification 2010. Results: A total of 1256 children
under 12 years of age were referred to the Neurophysiology Department. Among
them, 162 (12.90%) fulfilled the inclusion criteria. Most of the patients were male
(64.2%) and below 1 year (37.7%) of age. The majority (56.8%) were delivered at
the hospital and 40.1% had a history of perinatal asphyxia. Development was
age-appropriate before the onset of a seizure in 38.9% of cases. Most (53.7%)
of the patients had seizure onset within 3 months of age. Categorization of
Epileptic syndromes found that majority had West Syndrome (WS) (37.65%)
followed by Lennox-Gastaut syndrome (LGS) (22.22%), Otahara syndrome (11.73%),
Continuous spike-and-wave during sleep (CSWS) (5.66%), Myoclonic astatic
epilepsy (MAE) (4.94%), Early myoclonic encephalopathy (EME) (3.7%), Dravet syndrome
(3.7%) and Landau-Kleffner syndrome (LKS) (1.23%). 9.26% of syndromes were
unclassified. Conclusion: EEG was found to be a useful tool in the
evaluation of Epileptic encephalopathies. The clinico-electroencephalographic features
are age-related. Their recognition and appropriate management are critical.