Clinico-etiological Profile and Developmental Status of Infants Aged 1–24 months with Epilepsy

  • Pankaj Kumar Sahu
  • Devendra Mishra
  • Monica Juneja
  • Kushagra TanejaEmail author
Original Article



To study the clinico-etiological profile of epilepsy in children aged 1–24 mo attending a tertiary-care public hospital.


All infants aged 1–24 mo with epilepsy (as per International League Against Epilepsy, 2014) presenting between April 2016 and March 2017 were enrolled. Detailed history and examination were done in all children, and developmental assessment was done using Developmental Assessment Scale for Indian Infants (DASII). Electroencephalography and neuroimaging (CT/MRI) were done for all subjects.


Sixty children (39 males) were consecutively enrolled after informed written consent. The mean (SD) age at seizure onset was 4.3 (4.14) mo. Perinatal asphyxia (45%) and malformations of cortical development (18.3%) were the commonest etiologies. Neurological examination was abnormal in 68.3%, and a neuroimaging abnormality was present in 76% of children. Fifteen patients (25%) had West syndrome, which was symptomatic in the majority (73.3%). Developmental delay (DQ < 70) was the commonest co-morbidity (81.7%); 28.3% had profound delay. Odds of having developmental delay were 13-times higher in those with an abnormal neurological examination [OR 13.5 (2.82–64.67), P = 0.001], and nearly 9-times higher with abnormal neuroimaging [OR 8.9 (2.11–37.9), P = 0.003].


Epilepsy in children <2 y is symptomatic in the majority, with sequelae of birth asphyxia as the commonest etiology. High prevalence of co-morbid developmental delay underscores the need for routine evaluation and early intervention in all high-risk infants.


Electroencephalography Neuroimaging Outcome Seizures 



The authors are thankful to Dr. Sapna Singh, Professor, Department of Radiodiagnosis, for her help in reporting on the study investigations.

Authors’ Contribution

PKS, DM, MJ, KT: Study planning; PKS, DM: Subject assessment and evaluation; DM, KT: Statistical analysis; PKS, KT, DM: Manuscript writing. All authors made important intellectual contribution to study planning, data analysis, and manuscript writing. All authors approved the final manuscript. DM would be the guarantor.

Compliance with Ethical Standards

Conflict of Interest



  1. 1.
    Hauser WA, Annegers JF, Kurland LT. Incidence of epilepsy and seizures in Rochester, Minnesota: 1935–1984. Epilepsia. 1993;34:453–6.CrossRefGoogle Scholar
  2. 2.
    Wilmshurst JM, Gaillard WD, Vinayan KP, et al. Summary of recommendations for the management of infantile seizures: task force report for the ILAE Commission of Pediatrics. Epilepsia. 2015;56:1185–97.CrossRefGoogle Scholar
  3. 3.
    Eltze CM, Chong WK, Cox T, et al. A population-based study of newly diagnosed epilepsy in infants. Epilepsia. 2013;54:437–45.CrossRefGoogle Scholar
  4. 4.
    Altunbaşak S, Incecik F, Hergüner O, Refik Burgut H. Prognosis of patients with seizures occurring in the first 2 years. J Child Neurol. 2007;22:307–13.CrossRefGoogle Scholar
  5. 5.
    Battaglia D, Randò T, Deodato F, et al. Epileptic disorders with onset in the first year of life: neurological and cognitive outcome. Eur J Paediatr Neurol. 1999;3:95–103.CrossRefGoogle Scholar
  6. 6.
    Matsumoto A, Watanabe K, Sugiura M, Negoro T, Takaesu E, Iwase K. Etiologic factors and long-term prognosis of convulsive disorders in the first year of life. Neuropediatrics. 1983;14:231–4.CrossRefGoogle Scholar
  7. 7.
    Kharod P, Mishra D, Juneja M. Drug-resistant epilepsy in Indian children at a tertiary-care public hospital. Childs Nerv Syst. 2019 Feb 13. [Epub ahead of print].
  8. 8.
    Udani V, Munot P, Ursekar M, Gupta S. Neonatal hypoglycemic brain-injury: a common cause of infantile onset remote symptomatic epilepsy. Indian Pediatr. 2009;46:127–32.Google Scholar
  9. 9.
    Singhi P, Ray M. Profile of west syndrome in north Indian children. Brain Dev. 2005;27:135–40.CrossRefGoogle Scholar
  10. 10.
    Sehgal R, Gulati S, Sapra S, Tripathi M, Kabra M, Pandey RM. Neurodevelopmental and epilepsy outcome in children aged one to five years with infantile spasms – a north Indian cohort. Epilepsy Res. 2014;108:526–34.CrossRefGoogle Scholar
  11. 11.
    Nikunj NK, Mishra D, Juneja M, Talukdar B. Etiology and short-term outcome of first seizure in hospitalized infants. Indian Pediatr. 2016;53:924–6.Google Scholar
  12. 12.
    Wilmshurst JM, Birbeck GL, Newton CR. Epilepsy is ubiquitous, but more devastating in the poorer regions of the world... or is it? Epilepsia. 2014;55:1322–5.CrossRefGoogle Scholar
  13. 13.
    Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55:475–82.CrossRefGoogle Scholar
  14. 14.
    Phatak P. Manual for Using Developmental Assessment Scales for Indian Infants (DASII): Based on Revised Baroda Norms. Pune: Anand Agencies; 1997. p. 1–7.Google Scholar
  15. 15.
    Dhinakaran R, Mishra D. ILAE classification of seizures and epilepsies, 2017: an update for the pediatrician. Indian Pediatr. 2019;56:60–2.CrossRefGoogle Scholar
  16. 16.
    Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the international league against epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58:522–30.CrossRefGoogle Scholar
  17. 17.
    Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58:512–21.CrossRefGoogle Scholar
  18. 18.
    Partikian A, Mitchell WG. Neurodevelopmental and epilepsy outcomes in a north American cohort of patients with infantile spasms. J Child Neurol. 2010;25:423–8.CrossRefGoogle Scholar
  19. 19.
    Berg AT, Loddenkemper T, Baca CB. Diagnostic delays in children with early onset epilepsy: impact, reasons, and opportunities to improve care. Epilepsia. 2014;55:123–32.CrossRefGoogle Scholar
  20. 20.
    Rantala H, Ingalsuo H. Occurrence and outcome of epilepsy in children younger than 2 years. J Pediatr. 1999;135:761–4.CrossRefGoogle Scholar
  21. 21.
    Ahmed S, Alam ST, Rahman MM, Akhter S. Clinical profile of early childhood epilepsy: a cross sectional study in a tertiary care hospital. Mymensingh Med J. 2016;25:96–101.Google Scholar
  22. 22.
    Handryastuti S, Mangunatmadja I. Risk factors influencing the outcomes in infants with epilepsy. Paediatr Indonesia. 2007;47:202–6.CrossRefGoogle Scholar
  23. 23.
    Hsieh DT, Chang T, Tsuchida TN, et al. New-onset afebrile seizures in infants: role of neuroimaging. Neurology. 2010;74:150–6.CrossRefGoogle Scholar
  24. 24.
    Gaillard WD, Chiron C, Cross JH, et al; ILAE Committee for Neuroimaging, Subcommittee for Pediatric. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia. 2009;50:2147–53.CrossRefGoogle Scholar
  25. 25.
    Cheverie JJ, Aicardi J. Convulsive disorders in the first year of life: neurological and mental outcome and mortality. Epilepsia. 1978;19:67–74.CrossRefGoogle Scholar
  26. 26.
    Masri A, Badran E, Hamamy H, Assaf A, Al-Qudah AA. Etiologies, outcomes, and risk factors for epilepsy in infants: a case-control study. Clin Neurol Neurosurg. 2008;110:352–6.CrossRefGoogle Scholar
  27. 27.
    Vanderlinden L, Lagae LG. Clinical predictors for outcome in infants with epilepsy. Pediatr Neurol. 2004;31:52–5.CrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  1. 1.Department of PediatricsLok Nayak Hospital and Maulana Azad Medical College (University of Delhi)New DelhiIndia

Personalised recommendations