{'fraction_non_alphanumeric': 0.03210222845566464, 'fraction_numerical': 0.02337540906965872, 'mean_word_length': 4.834545454545455, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
To study the clinical profile of children presenting with history of focal seizure for the first time in OPD/IPD in the pediatric age group of 1-18 years and To study multi detector CT findings in children with focal seizures

Background: Seizure is defined as transient, involuntary alteration of consciousness, behaviour, motor activity, sensation, or autonomic function caused by an excessive rate and hypersynchrony of discharges from a group of cerebral neurons 1 . Partial or focal seizures have specified area of origin. The behavioural manifestations of focal seizures are related not only to the part of the brain involved but also to the maturation of the nervous system and integrity of the pathway necessary for clinical expression. New onset partial seizures in an otherwise asymptomatic child may be idiopathic or symptomatic. Common causes of focal seizures reported in India and developing countries are perinatal insult, gliomas, cortical dysplasias, infarcts, neurocysticercosis (NCC) and tuberculomas 2 . This study was done to find out the clinical profile of focal seizures in pediatric age group and various etiologies related to it. Methods: It was a hospital based non-interventional prospective study done over a period of one year. All the children 37 were enrolled after meeting inclusion criterias. All the findings were recorded in a pre designed proforma and results were analysed by window SSPE software. Results: In this study, we enrolled 37 patients. The mean ± SD age of presentation was 10.43 years ( 4.18 yrs) with a range of 3 17 years. Male : female ratio was 1.3:1. 6(16.2%) cases presented with simple partial seizures while 28(75.7%) presented with complex partial seizures. Three patients (8.1%) had focal onset with secondary generalization. Twenty two (59.5%) had left sided and 15(40.5%) had right sided seizures. Twenty patients (54.1%) had more than one episode of seizure prior to being enrolled in the study, 17(45.9%) patients had a first presentation of focal seizure. Eight (21.6%) had single episode while 9(24.3%) had more than multiple episodes of seizures at the time of presentation. an underlying focus of seizure was found in 26(70.2%) patients. Granuloma, in the form of a ring enhancing lesion was seen in 17(45.9%) cases while in 3(8.1%) patients, a structural lesion was seen. There was an area of gliosis in 3(8.1%) and vascular insult/infarct in 3(8.1%) patients. CT scan was normal in11(29.7%) patients. Conclusion  Inflammatory granulomas are the most common cause of partial seizures.  Neuroimaging is a valuable tool in identifying etiology of focal seizures.


Introduction
Seizures are the most common pediatric neurologic disorders, with 4%-10% of children suffering at least one seizure in the first 16 years of life. Epidemiologic studies reveal that approximately 150,000 children will sustain a first-time, unprovoked seizure each year, and of those, 30,000 will develop epilepsy 3 . Focal seizures are further divided into simple partial seizures and complex partial seizures on the basis of loss of conciousness 4 . Majority of the focal seizures in pediatric population are associated with some underlying cause which can be managed medically and because of this reason this study was undertaken.

Materials Study Design:
This was a hospital based noninterventional prospective study done at a tertiary care hospital under Department of Pediatrics and Radio-diagnosis. Study Period: July 2013 to July 2014 Inclusion Criteria 1. All children between 1-18 years age group presenting with focal seizures or history of focal seizures in past. Exclusion Criteria 1. Children with past history of focal seizure already evaluated for the cause. 2. Children with generalized seizures. After approval from institutional ethical committee, all children in the age group 1-18 years, having any episode of focal seizures not evaluated for underlying cause earlier, presenting during the study period were enrolled in this study after getting informed consent . A total of thirty seven (37) patients of partial seizures met the inclusion criteria and were included in the study. A detailed history and clinical examination was done in all cases. Children with focal seizures were managed as per protocol and investigated for the etiology of focal seizures with relevant investigations. All the findings were recorded in a pre designed proforma and results were analysed by window SSPE software. All these patients were subjected to CT scan head plain and contrast as and when required and other investigations wherever indicated. CT scan specifications: CT scan used during the study was multi-detector 16 slides Philips Brilliance. Plain and contrast enhanced images of head were obtained. Contrast medium used in the imaging was non-ionizing Isohexol given intravenously.

Age distribution
In this study, we enrolled 37 patients. The mean ± SD age of presentation was 10.43 years ( 4.18 yrs) with a range of 3 -17 years.  Family history of seizures Only 2(5.4%) patients had positive family history of seizure and 3(8.1%) patients had developmental delay in one or more sphere.

Association of seizure with fever
Only one patient had associated fever at the time of presentation. Relation with dietary habit Twenty six (70.3%) studied subjects were consuming mixed diet and 11(29.7%) were only vegetarian. There is preponderance toward mixed diet consumers.

CT scan head findings in partial seizures
CT scan was done in all cases and an underlying focus of seizure was found in 26(70.2%) patients.

NCC serology
Neurocysticercosis serology was carried out only in patient with ring/disc enhancing lesion. So from this study we can conclude that in developing countries like India computed tomography is a useful, affordable, and easily available investigation modality in patients with focal seizures. However repeated and unnecessary exposures should be avoided keeping in view the fact that no imaging study be done unless there is a clear medical benefit that outweighs any associated risk.

Conclusion
 Inflammatory granulomas are the most common cause of partial seizures.  Neuroimaging is a valuable tool in identifying etiology of focal seizures.  Due to high yielding potential of CT scan in focal seizure, easy availability and affordability, makes it the investigation of choice in focal seizures in developing countries like India.