Clinicoradiological Evaluation of Newly Diagnosed Epilepsy: A Monocentric Prospective Study from a Tertiary Care Hospital of Eastern India

Introduction: “Newly diagnosed epilepsy” is defined as a subset of epileptic disorder, which presented or diagnosed first time during study period, and had two or more than two episodes of seizure. Early evaluation and diagnosis of Epilepsy is very important for better treatment.

Aim: Aim of study was to evaluate epidemiological, clinical profile, as well as radiologic characteristics in cases of newly diagnosed epilepsy and to find out correlation between them.

Materials and Methods: It was a prospective and descriptive study of 1-year duration, conducted in the department of neurology in Sriram Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India. Three hundred newly diagnosed epilepsy patients, more than 5 years of age, were included and subjected to detail clinical and radiological evaluation.

Results: Majority patients in our study were from second and third decades (mean age = 25 years, SD = 11.04) with characteristic male preponderance. Most patients were from rural Background: and majority of them (60%) attended neurology clinic after 3 to 10 episodes of seizures. Seizures in awake state and seizures without precipitating factors were more common. Headache was the most common prodromal symptom. Generalized seizure dominated over focal seizure (62:34) with tonic–clonic type (66.67%) being most common in the generalized seizure cohort. Focal seizure with secondary generalization was seen in 70.5% cases. Drowsiness (38%) and Todd's palsy (6%) were most and least common postictal symptoms in our study. Our study also revealed abnormal computed tomography (CT) findings in 70.6% of focal seizures and 24.2% of generalized seizures. Magnetic resonance imaging (MRI) was abnormal in 53.6% of cases. Granulomatous lesion was dominant neuroimaging finding in our study.

Conclusion: This study concluded that males of second and third decades from rural Background are highly prone to epilepsy. Infectious causes like neurocysticercosis and tuberculoma are predominant etiologies in our area. Neuroimaging plays an important role in establishing and localizing etiology of seizure. Any patient coming with history of epilepsy or suspected as a case of newly diagnosed epilepsy must be investigated with neuroimaging for further management.