Clinical Profile, Etiology and Outcome of Afebrile Seizures in Children

Afebrile seizures are a significant neurological disorder in children, with diverse etiologies and clinical presentations. Early diagnosis and appropriate management are essential for improving outcomes and reducing long-term complications. Understanding the clinical profile, causes, seizure types, and treatment outcomes can aid in optimizing pediatric epilepsy care.Aim:To investigate the clinical profile, causes, seizure types, and treatment outcomes of afebrile seizures in children aged 6 months to 18 years, and to classify seizures according to ILAE 2017 guidelines. Methods: A prospective observational study was conducted over 18 months at the Postgraduate Department of Pediatrics, G.B. Pant Children Hospital, Srinagar. A total of 100 children with afebrile seizures were enrolled. Detailed demographic data, clinical history, physical examination findings, and relevant investigations (EEG, CT, MRI) were recorded. Seizures were classified according to ILAE 2017 guidelines, and patients were followed for 6 months to assess seizure control and outcomes. Statistical analysis was performed using SPSS version 21.0.Results: Among 100 children, 60% were male and 40% female, with a male-to-female ratio of 3:2. The median age at onset was 39 months. Generalized seizures were most common (75%), followed by focal seizures (19%) and unknown onset (6%). Structural abnormalities were the leading identifiable cause (60%), followed by metabolic (14%), genetic (7%), infectious (5%), and immune (1%) etiologies, while 13% remained undetermined. EEG abnormalities were present in 80% of cases, and CT scan abnormalities were found in 42% of scanned children. Good seizure control was achieved in 79.3% of cases, predominantly with monotherapy. Factors associated with poor seizure control included recurrent seizures, structural etiology, abnormal EEG, and the need for polytherapy. Conclusion: Afebrile seizures in children show a diverse clinical and etiological spectrum. Generalized seizures are most common, with structural abnormalities being the leading identifiable cause. Early evaluation with EEG and neuroimaging, coupled with appropriate antiepileptic therapy, results in favorable outcomes in most cases. High-risk children with symptomatic epilepsy require closer follow-up and individualized management. Multicentric studies are recommended to further validate these findings and improve community-level epilepsy care.