Etiological spectrum of symptomatic localization related epilepsies: a study from South India.
Putative etiology was studied in 991 patients with symptomatic localization-related epilepsies seen in a university hospital in South India. They formed 39% of patients with various types of epilepsies and epileptic syndromes seen during the study period. Seizure occurred in close temporal association with an acute central nervous system (CNS) insult in 53% of patients. Infections of CNS including single CT enhancing lesion (SCTEL) accounted for 77% of patients with acute symptomatic epilepsy. Cerebrovascular diseases were the risk factors in 48% of patients with remote symptomatic epilepsy. Neurocysticercosis, SCTEL and small single cerebral calcific CT lesion (SSCCCTL) together accounted for 40% of etiological factors and neurotuberculosis for 10%. Infections of the central nervous system and SCTEL together were the putative risk factors in 52% of patients aged < or =40 years. Cerebrovascular diseases were the etiological factors in 64% of patients aged >40 years. Neurological handicaps from birth manifested by mental retardation and/or cerebral palsy was the feature in 21% of children. The type of seizure was either simple partial or complex partial with or without secondary generalization in 76% of patients. The remaining patients presented with either generalized tonic clonic seizures or unlocalized seizures. Localization to a single site of seizure origin proposed by the International League Against Epilepsy (ILAE) was possible in only 67.5% of patients. The most readily identifiable was motor cortex. In patients with unlocalized or generalized seizures the type of pathology was diffuse in 17% of patients and in 48.5% of patients, the lesion was located in the frontal brontoparietal lobe.
Department of Neurology, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, India.
J M
JM
Murthy
R
R
Yangala
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D002547:Cerebral Palsy / Q000150:complications / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000150:complications / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003551:Cysticercosis / Q000150:complications / Q000453:epidemiology; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications / Q000453:epidemiology / Q000382:microbiology / Q000469:parasitology; D004828:Epilepsies, Partial / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014390:Tuberculosis, Meningeal / Q000150:complications / Q000453:epidemiology