PAEDIATRICS BRAIN IMAGING IN EPILEPSY: COMMON PRESENTING SYMPTOMS AND SPECTRUM OF ABNORMALITIES DETECTED ON MRI

Authors

  • Azmat Ali
  • Faiza Akram
  • Ghayyur Khan
  • Shaukat Hussain

Abstract

Background: Epilepsy, a common neurological disorder can present at any age and has a number of aetiologies with underlying brain disease being the most common aetiology. Brain imaging becomes important and mandatory in the work up for epilepsy in localization and lateralization of the seizure focus. Methods: This cross-sectional study was conducted in the department of Radiology Ayub Medical Teaching Institution Abbottabad from 1st March 2015 to 31st March 2016. A total of 209 children aged 28 days to 14 years were included in the study who presented with seizures to clinicians. Information obtained from history, clinical examination and investigations especially MRI brains were recorded in a prescribed pro forma. The data was analysed in SPSS 20. Results: MRI examination was unremarkable in 44.01% (n=92) and mild generalized brain atrophy was noted in 12.91% (n=27). Arachnoid cysts, mild unilateral brain atrophy and hydrocephalous due to aqueduct stenosis were recorded in 3.82% (n=8) of each group. Neoplastic lesions were the second most common abnormal MRI finding and constituted 5.74% (n=12). Leukodystrophy was diagnosed in 4.78% (n=10). MRI examination showed ring enhancing lesions (tuberculomas) and AVM in 1.43% (n=3) of each group. Perinatal ischemia and intracranial infection, (focal or generalized) were recorded in 2.87% (n=6) of each group. A 0.95 % (n=2) of children in each group had agenesis of corpus callosum and cavernoma. The radiological MRI diagnosis of Raussmussen encephalitis was made in 3.34% (n=7). Single case, each of mesial temporal sclerosis, subdural haemorrhage, infarct and craniopharyngioma was recorded making 0.47 % of the total patients in each case. Conclusion: MRI examination was abnormal in significant number of patients (55.86%), so therefore if properly utilized, in a good clinical context, this can identify most of the structural brain abnormalities in paediatric patients presenting with seizures.Keywords: Brain imaging; MRI; epilepsy; Paedriatics; Abnormalities; Radiology

References

Khatri ST, Iannaccone ST, Ilyas MS. Abdullah M, Saleem S. Epidemiology of Epilepsy in Pakistan: review of literature. J Pak Med Assoc 2003;53(12):594–7.

Malik MA, Akram RM, Tarar MA, Sultan A. Childhood epilepsy. J Coll Physician Surg Pak 2011;21(2):74–8.

Jackson GD, Briellmann RS, Kuzniecky RI. Temporal lobe Epilepsy. In: Kuzniecky RI, Jackson GD, editors. Magnetic Resonance in Epilepsy, 2nd ed. 2005. p.99–220.

Bronen RA, Gupta V. Epilepsy. In: Atlas SW editor. Magnetic Resonance Imaging of Brain and Spine. 4th ed, 2009. p.307–42.

Resta M, Palma M, Dicuonzo F, Spagnolo P, Specchio LM, Laneve A, et al. Imaging studies in partial epilepsy in children and adolescents. Epilepsia 1994;35(6):1187–93.

Amirsalari S, Saburi A, Hadi R, Torkaman M, Beiraghdar F, Afsharpayman S, et al. Magnetic resonance imaging findings in epileptic children and its relation to clinical and demographic findings. Acta Med Iran 2012;50(1):37–42.

Chaurasia R, Singh S, Mahur S, Sachan P. Imaging in pediatric epilepsy: spectrum of abnormalities detected on MRI. J Evol Med Dent Sci 2013;19(2):3377–87.

Hsieh DT, Chang T, Tsuchida TN, Vezina LG, Vanderver A, Siedel J, et al. New-onset afebrile seizures in infants: role of Neuroimaging. Neurology 2010;74(2):150–6.

Guissard G, Damry N, Dan B, David P, Sekhara T, Ziereisen F, et al. Imaging in pediatric epilepsy. Arch Pediatr 2005;12(3):337–46.

Theodore WH, Dorwart R, Holmes M, Porter RJ, DiChiro G. Neuroimaging in refractory partial seizures - comparison of PET, CT and MRI. Neurology 1986;36(6):750–9.

Spooner CG, Berkovic SF, Mitchell LA, Wrennall JA, Harvey AS. New-onset temporal lobe epilepsy in children: lesion on MRI predicts poor seizure outcome. Neurology 2006;67(12):2147–53.

Gaillard WD, Weinstein S, Conry J, Pearl PL, Fazilat S, Fazilat S, et al. Prognosis of children with partial epilepsy: MRI and serial 18FDG-PET. Neurology 2007;68(9):655–9.

Betting LE, Mory SB, Lopes-Cendes I, Li LM, Guerreiro MM, Guerreiro CA, et al. MRI reveals structural abnormalities in patients with idiopathic generalized epilepsy. Neurology 2006;67(5):848–52.

Gelisse P, Corda D, Raybaud C, Dravet C, Bureau M, Genton P. Abnormal neuroimaging in patients with benign epilepsy with centrotemporal spikes. Epilepsia 2003;44(3):372–8.

Labate A, Ventura P, Gambardella A, Le Piane E, Colosimo E, Leggio U, et al. MRI evidence of mesial temporal sclerosis in sporadic "benign" temporal lobe epilepsy. Neurology 2006;66(4):562–5.

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