Aims and Objectives: (1) To determine the frequency of abnormal Electroencephalogram in children presenting with first-onset afebrile and complex febrile seizures. (2) To find out most common EEG patterns associated with first-onset afebrile and complex febrile seizures.

Study Design:- It was an observational prospective, stratified randomized cohort study done in a tertiary care hospital in a metropolitan city.

Materials and Methods:- The study was approved by the Institutional ethical committee. The patients attending the Emergency, in-patient and outpatient Departments of Pediatrics Division of ourinstitute were enrolled for the study as per the criteria given. It was a prospective, stratified-randomized cohort study conducted on children in the age group of 6 months to 12 years having first-onset unprovoked seizures and Complex febrile seizures.

Results:- The mean age of seizure occurrence was 6.3 years. Male preponderance was noticed with a ratio of 1.63:1.EEG abnormalities were seen jn 40 patients (40%). EEG abnormalities were most commonly associated with partial seizures (53.57%) followed by generalized seizures (40%). EEG abnormalities were least commonly seen with complex febrile seizures (21.85%). Sharp and spike waves, alone or in the combination were overall most common EEG findings.  In generalized seizures, most common EEG abnormality found was sharp waves which were seen in 8/18(44.44%). Second most common pattern of EEG abnormality in generalized seizures were either spike waves 3/18(16.67%) or sharp and spike waves 3/18(16.67%). Asymmetry with sharp waves and abnormal background with sharp waves are seen in 2/18 (11.11%) patients each. In partial seizures, most common pattern of EEG abnormality was spike waves seen in 4/15 (26.67%) second most common EEG abnormality in partial seizures was abnormal background with sharp waves and spikes which was seen in 3/15(20%).sharp waves, sharp and spike waves and asymmetry with sharp and spike waves. Incidence of each of these EEG abnormalities was same I e 2/15 (13.33) while asymmetry with sharp waves was seen in 1 patient (6.67%). In complex febrile seizures Asymmetry with sharp waves and spike, abnormal background with sharp waves and asymmetry with sharp waves were most common EEG abnormalities seen in 4/7(57.14%), 2/7(28.57) and 1/7(14.29%) patients respectively.

Conclusion: EEG, preferably 3-4 days after the seizures, should be done in all pediatric patients presenting either with first onset afebrile or complex febrile seizures.

Keywords: Electroencephalogram, First onset afebrile seizures, complex febrile seizures

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Dr Mohammed Ashfaque Tinmaswala

Senior Resident, Grant Government Medical College and JJ Group Of Hospital Mumbai

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