Clinical Profile and Prediction of Response to Treatment in Childhood Epilepsy - A Single-Centre Experience from Eastern India

Author(s): Prakash Chandra Ghosh1, Mitali Bera2, Punyabrata Barma3, Arijit Roy4, Sananda Majumder5, Debshankar Guin6, Alak Pandit7, Gautam Ganguly8

Though epilepsy remains a significant problem for children and adolescents in our
country, studies delineating the clinical profile and response to treatment in
childhood epilepsy are lacking. The current study was carried out for obtaining a
baseline profile and to predict the response to treatment in childhood epilepsy in
India that may be helpful in planning management strategies from a public health
point of view.
Patients with clinical suggestion of active epilepsy (N = 141) from one month to
12 years, were enrolled into the study over a period of 1 year (February 2010 to
January 2011) from the out-patient department and epilepsy clinic of Bangur
Institute of Neurology. Detailed history was taken along with neurological
examination. Electroencephalography (EEG) and neuroimaging (MRI / CT scan)
were done on all patients. Each patient included in the study was kept in followup
for a period of 6 months and their response to the treatment was recorded.
About 48.9 % (N = 69) patients had localisation related epilepsy while the rest
had generalised epilepsy. Of those with generalised epilepsy, generalised tonicclonic
seizures (GTCS) was by far the most common type. Of those with focal EEG
activity, the highest proportion (50 %), were localised to the temporal lobe.
Symptomatic aetiology accounted for 59.6 % (N = 84) of the patients. 20.6 % (N
= 29) had poor response to treatment at 6 months follow-up. Abnormal
neuroimaging (OR = 6.708) and abnormal EEG (OR = 6.357) were effective factors
in predicting poor response to treatment.
Our study highlights the need to link specialised epilepsy services with primary
health centres for early detection and treatment. EEG is an essential cost-effective
modality in determining seizure localisation and response to treatment.