VYSHNAVIKORNI THESIS
Title: CLINICAL PROFILE, ETIOLOGICAL FACTORS AND OUTCOMES OF ADULT ONSET SEIZURES
NEED FOR STUDY :
Globally, seizures are common disorders recognized since antiquity and are encountered frequently during medical practice; up to 10% of general population experience at least one seizure in their lifetime with the highest incidence occurring in early childhood and late adulthood. Seizures beginning in the adult life require special attention as regards to their etiology because these are likely to be due to an identifiable cause. These are mainly due to trauma, central nervous system (CNS) infections, space-occupying lesions, cerebrovascular accidents (CVA), metabolic disorders, and drugs. On the other hand, seizures beginning in childhood are more likely to be idiopathic. In addition, the etiology and clinical profile of seizures in adults necessitate decisions about the initiation and discontinuation of pharmacotherapy that are different from those in younger patients
INTRODUCTION:
A seizure is a sudden, uncontrolled burst of electrical activity in the brain. It can cause changes in behavior, movements, feelings and levels of consciousness. Having two or more seizures at least 24 hours apart that don't have a known cause is considered to be epilepsy.
There are many types of seizures, and they have a range of symptoms and severity. Seizure types vary by where they begin in the brain and how far they spread. Most seizures last from 30 seconds to two minutes. A seizure that lasts longer than five minutes is a medical emergency.
Seizures can happen after a stroke or a head injury. They also may be caused by an infection such as meningitis or another illness. Many times, though, the cause is unknown.
Nerve cells in the brain, known as neurons, create, send and receive electrical impulses. This allows the cells to communicate. Anything that disrupts the communication pathways can lead to a seizure. Some types of seizures may be caused by genetic changes.
The most common cause of seizures is epilepsy. But not every person who has a seizure has epilepsy. Sometimes seizures may be caused or triggered by:
A high fever. When this happens, the seizure is known as a febrile seizure.
An infection of the brain. This may include meningitis or encephalitis.
Severe general illness, including a severe infection of COVID-19.
Lack of sleep.
Low blood sodium. This can happen with medicine that makes you urinate.
Certain medicines that treat pain, depression or help people stop smoking. They can make it easier for seizures to happen.
A new, active brain injury, such as head trauma. It can cause bleeding in an area of the brain or a new stroke.
The use of legal or illegal drugs that may be sold on the streets, such as amphetamines or cocaine.
Alcohol misuse, including during times of withdrawal or extreme intoxication.
Most seizures can be controlled with medicine. However, managing seizures can affect your daily life
AIM: To analyse the clinical profile, etiological factors and outcomes in patients with new onset seizures in adults
OBJECTIVES:
1. To assess the clinical profile of patients with new onset seizures
2. To study the underlying etiological factors that cause seizures
3. To study the patient centred outcomes in patients with new onset of seizures
MATERIALS AND METHODS :
PLACE OF STUDY : Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally.
STUDY PERIOD : november 2023-october 2025
STUDY DESIGN : Prospective Study, Observational study
SAMPLE SIZE :
No.of cases to be studied =50
INCLUSION CRITERIA:
1. Patients of any gender above or equal to 18 years of age at the time of presentation.
2. Patients who have given their informed consent for the study.
EXCLUSION CRITERIA:
1. Patients under the age of 18 years
2. Patients/Patients attendants who are not willing for study or not giving consent for the purpose of study
3. Psychogenic seizures
4. Eclampsia
CASE PROFORMA:
SERIAL NO:
NAME:AGE:
OP/IP NO.:
EDUCATION:
OCCUPATION:
SOCIOECONOMIC STATUS:
PHONE NUMBER:
ADDRESS:
COMPLAINTS:
Involuntary movements
-Time of onset
-duration
-Aura
-precipitating factors
-Loss of consciousness, tongue bite, bladder bowel incontinence, post ictal confusion, residual neurological deficit
-No. of episodes
Fever
Headache
Vomitings
PAST HISTORY: History of diabetes type2, Hypertension, CVA, Meningitis, TB
FAMILY HISTORY:
PERSONAL HISTORY:
GENERAL EXAMINATION:
CNS EXAMINATION:
Higher mental functions
Cranial nerves
Motor system
Sensory system
Reflexes
ANS
Meningeal signs
RESPIRATORY SYSTEM
CARDIO VASCULAR SYSTEM
GASTROINTESTINAL SYSTEM
INVESTIGATIONS:
Hemogram, RBS, Urea, creatinine, electrolytes, CUE,Chestxray, EEG, Brain imaging
EXPECTED OUTCOMES:
Recovery, recurrence leading to morbidity requiring hospital stay, mortality
CONSENT:
I/WE, relative of the patient have read and understood the information provided in the patient information sheet and have been informed the purpose of the evaluation in the language I understand.
I am aware of the fact that I may not derive any benefit from the evaluation and that I deserve the right to opt out of the study at any point of time.
I willingly agree to participate in this study.
Patients sign/thumb impression: witness sign/thumb impression.
Name:
Date:
Residents sign:
Resident name:
date:
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