NEWLY DIAGNOSED SEIZURES IN ADOLESCENTS: A COMPARATIVE STUDY

OBJECTIVE: To study the clinical, EEG and CT profile in a hospital population of adolescents with newly diagnosed recurrent seizures. METHODS: The clinical profiles obtained from history including detailed descriptions of the seizures, examination, electroencephalographic (EEG) and computed tomography (CT) findings were recorded prospectively for all 14 to18-year-old patients who were referred to the electrodiagnostic service at King Fahd Hospital of the University, Al- Khobar, Eastern Province, Saudi Arabia from 1(st) January 1996 to 31(st) December 1997. The data were entered into a standard dbase file and analyzed using a personal computer. The results were compared with 2 previous concomitant subsets of data obtained from 263 children ≤13 years (72%) and 73 adults > 18 years (20%) over the same study period. RESULTS: Twenty-nine patients (14 males and 15 females, a mean age of 15.7 years) with newly diagnosed recurrent seizures were studied. A positive family history of seizures was found in 10.3%. The main seizure types were partial in 11 (37.9%), partial with secondary generalization in 6 (20.7%) and generalized in 12 (41.4%). The types of epileptic syndromes included localization-related 15 (51.7%), generalized 12 (41.4%) and undetermined 2 (16.9%). The EEG was abnormal in 21 (72.4%) with epileptiform activity, focal in 11 (52.4%), generalized in 9 (42.8%) and none-epileptiform activity in 1 (4.8%). The cranial CT findings were normal in 21 patients (72.4%) and abnormal in 8 (27.6%) patients, with focal lesions in 6 (75%) and generalized cerebral atrophy in 2 (25%). The frequency of adolescents presenting with newly-diagnosed seizures was 8% of the total study population of 365 patients including children and adults. CONCLUSION: The results showed that partial and partial with secondary generalization seizures and the localization-related epileptic syndrome are the most frequent seizure and epileptic syndrome types in adolescents. The least frequent of newly diagnosed seizures in adolescents compared to children and adults confirms the bimodality of peak frequency in the young and old that has been observed in the west.