tchin Naidu M
Seizures are common disorder found all over the world and are encountered frequently during medical practice in a variety of settings. At the global level, it is estimated that nearly 70 million people suffer from epilepsy and the prevalence of epilepsy across the globe is estimated to be 5-9 per 1,000 populations. About 12 million persons with epilepsy live in India. Numbers of deaths attributed to epilepsy in 2015 were 7419 for 10,000 population and deaths attributable to epilepsy were 0.21% of total deaths globally. Idiopathic seizures account for most of the hospital admissions. Aetiological spectrum of acute symptomatic seizure in developing countries is different from developed countries. Studies from developed countries showed CVA as the leading cause of new onset seizures. CNS infections like Malaria, Tuberculosis, HIV, Neurocysticercosis account for significant number of cases in developing countries like India. Since these infections vary from region to region. Aetiology of seizure may vary from region to region. Single small enhancing CT lesions (SSECTL) are important cause of seizures in India. Initially it was thought that SSECTL were because of Tuberculosis focal encephalitis and micro abscess were due to Cysticercosis but now studies suggest that, in most of the cases of SSECTL Neurocysticercosis predominates. So, aetiology changes over time. Focal seizures are more common, but they may generalize to life threatening status epilepticus. Most common causes for this type of presentation include subdural haemorrhage, stroke, central nervous system infections, degenerative disorders like Alzheimer’s disease and space occupying lesions including malignancy (glioma and brain metastasis). They also occur in systemic metabolic conditions like uremia, hyperglycemia, hypoglycemia, hypernatremia, alcohol withdrawal. Seizures can be a presenting feature in TB meningitis which is most common type of chronic meningitis in India. More than 60% patients with intracranial TB may have seizures. Our medical college is located in a predominantly coastal area. The ongoing disease spectrum and their complications are likely to be different from those encountered in metropolitan area. Hence this effort is made to know the various aetiologies of new onset seizures in adults in coastal area.
