Magnetic resonance imaging in childhood seizures

Nathiya Subramaniam., Elanchezhian., Ramesh S and Adaikkappan

Aim and Objective: To evaluate the diagnostic efficacy of a standard MRI of the brain in identifying the epileptic foci in children with seizures.

Methods: This is a prospective observational study where a total of 100 children aged 1 to 12 years with seizures who underwent MRI imaging of brain during the study period were included. All patients will be evaluated clinically and then undergo an MRI of the brain performed using a 1.5 Tesla MRI scanner. MRI scan was done and findings are recorded. Datas were collected and analyzed statistically.

Results: Out of 100 children with seizures who were included in the study, 74% had GTCS type of seizure and 26% had focal (partial) type of seizure. Both GTCS and focal seizures were observed to be common among males (54.1% and 61.5% respectively). Overall 58 children (58%) had normal MRI findings and 42(42%) had abnormal MRI imaging. Out of 71 children with abnormal EEG, 53.5% had normal MRI and 46.5% had abnormal MRI findings. All the children who had abnormal findings in MRI invariably had abnormal EEG and this association was found to be statistically significant (p-0.001). Out of 42 children with abnormal MRI findings, Hypoxic Ischemic changes and periventricular leucomalacia [21.4% (n=9)] is the commonest abnormality followed by other white matter lesions that constituted about 19%. Other findings were infection associated changes (14.3%), congenital malformations (14.3%), atropic changes (14.3%), vascular lesions (7.1%), CSF disorders (4.8%), tumors (4.8%).

Conclusion: As majority of seizures has its onset in childhood, evaluation of various etiologies of seizures is mandatory. Magnetic resonance imaging (MRI) is the most important noninvasive imaging modality, and is mandated in the evaluation of children with epilepsy together with electroencephalography. Using 3T MRI and other applications like MR spectroscopy, functional MRI and diffusion weighted MRI in evaluation of seizure will help identifying the etiology of seizure exactly which is the limitation of our study.

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