Patterns and Etiological Spectrum of Pediatric Seizures in an Emergency Department at Gabriel Touré University Hospital Centre

Abstract

Introduction: Seizures are the most common neurological emergency in paediatrics and are often the subject of heated debate in terms of their aetiology, diagnosis and treatment. There are numerous causes of seizures, including infectious, metabolic, toxic and traumatic conditions. Aim: The study aimed to investigate the causes of seizures in the paediatric emergency department at Gabriel Touré University Hospital. Materials and Methods: This is a prospective, cross-sectional, descriptive and analytical study conducted between 1 November 2023 to 31 October 2024 in children aged 1 month to 15 years admitted for convulsions. Data were collected on an individual survey form and gathered from interviews with parents, physical examinations of patients and hospital records. The chi-square test was used to compare qualitative variables. A p-value of <0.05 was considered statistically significant. Results: The frequency was 4.2%. The 13-59 month age group was the most represented (39.1%). The sex ratio was 1.7. The frequent reasons for consultation included convulsions + fever (31.8%), respiratory distress (20.9%), and altered consciousness + fever (10.6%). The convulsions were generalised tonic-clonic (73.5%), lasting less than 5 minutes (59.3%), and simple (67.9%), with post-critical coma in 77.8% of cases. Additional tests to confirm the aetiology included Rapid Diagnostic Test (RDT) and Gastroenteritis (GE) (47.7%), Cerebrospinal Fluid (CSF) Complete Blood Count (CBC) (29.9%), and EEG (6.6%). The main causes were neuropaludism (40.7%), acute dehydration (14.9%), meningitis (12.3%) and epilepsy (6%). The anticonvulsants used were: diazepam (93.4%), clonazepam (35.4%) and phenobarbital (4.3%). The case fatality rate was 24.2%. Conclusion: The main causes of convulsions are infections and acute dehydration. Malaria prevention and vaccination will help reduce the high mortality rate.