Profile of Children Admitted with Seizures in a Portuguese Level II Hospital within 8 Years

Background: Seizures are a common manifestation of several childhood pathologies, often requiring hospitalization due to associated morbidity and mortality.

Objective: Characterize the population admitted in a pediatric hospital service with seizures, detailed by age groups.

Methods: Retrospective analysis of all admissions from January 1st 2011 to December 31st 2018. Inclusion criteria: seizures as motive of hospital admission and age between 0 and 17 years and 365 days; children with seizures occurring only after hospitalization were excluded. The studied variables were clinical presentation, etiology, gender, age, comorbidities, origin and destination after discharge.

Results: A total of 146 patients were admitted for seizures, with predominance in male gender (61,4%) and in children under 4 years old (53,4%). It was the first episode in 46,6%, of which 26,5% had comorbidities. Presence of fever was commoner among 1-4 years old (48,3%). Generalized tonic-clonic were the most common type of crisis in every age group (41,1%); 7,5% presented in status epilepticus. The most common causes were epilepsy (33,6%) (prevailing in those older than 4 years old); complex febrile seizures (20,6%) (uppermost in those under 4 years old) and structural brain injury associated epilepsy (11,6%). Only 5 (3,4%) were due to infection of the central nervous system (CNS). There was 1 death (0,7%). There were abnormalities in 65,7% of the children who performed EEG (73,9%) and in 55.2% of those who underwent neuroimaging (19,9%).

Conclusion: The causes of seizures requiring hospitalization varies by age: complex febrile seizures in younger and epilepsy in older children. In this study, there were few episodes of CNS infection manifesting with seizures. Comorbidities may be an important predictor in first episode. A detailed medical history is crucial. Seizures require long-term surveillance: they can occur even when underlying pathology is identified and medicated and may require hospitalization for clinical stabilization.