Neuroimaging in pediatric seizures

Abstract

Background: Accurate etiological diagnosis of seizures in children is important to begin an effective treatment. MRI is an excellent neuroimaging tool that is highly accurate. It helps in diagnosis, determining the treatment protocol and predicting the outcome. Dedicated studies in paediatric population using MRI brain have been even fewer till date in India. Current study aims to find the common etiology of pediatric seizures on MRI in a developing country like India.Methods: Hospital based retrospective study. 105 cases in age group between 0 months to 12 years. Seen between 2014 till date included in the study. All cases underwent MRI.Results: Most common imaging findings were inflammatory granuloma in 10 (9.5%). Other findings were- Hypoxic ischemic encephalopathy (HIE) in 5 (4.7%), cerebral atrophy in 2 (1.9%), focal dysmyelination in 3 (2.8%), calcifying granuloma in 3 (2.8%) and periventricular leucomalacia in 2 (1.9%). Uncommon findings were that of lissencephaly, dysgenesis of corpus callosum, mesial temporal sclerosis, AV malformation, periventricular hemorrhage, schizencephaly, abscess and infarction in one child each (0.9% each). 69 children had no abnormal findings in brain.Conclusions: The commonest etiology of seizures is inflammatory granuloma. Early recognition of potentially treatable diseases helps in timely treatment and arrest of progression of disease. It is highly recommended to use MRI as primary investigation for seizures. Every effort should be made to provide facility of MRI for management of seizures in all parts of India.

Spectrum of MRI abnormalities in pediatric seizures

“…Our findings are similar to that of a study conducted by Kramer et al (1988) which detected neuroimaging abnormalities in 35% of patients [24]. Our study results are also consistent with a study done by Sahdev et al (2016) which revealed abnormal neuroimaging in 31.4% cases while in 68.6% of cases no abnormality was seen [1] However in a study conducted by Gulati et al (1991), the study revealed abnormal neuroimaging in 92.9% of the cases [13].…”

“…These results are similar to that of a study conducted by Shadev et al which also did not detect any brain tumor [1]. However, these results are different from that of the study conducted by Chaurasia et al (2013) which revealed a brain tumor in 4 (2.1%) cases [25].…”

“…In our study, the most common cause of seizures as identified by MRI brain was inflammatory granuloma (in 10% cases) while the second most common was a hypoxic-ischemic injury in 8% of patients. A similar study by Sahdev et al was conducted in India and it showed the most common cause of seizure in the age group of 0 months to 12 years was Inflammatory granuloma which included both tuberculoma and neurocysticercosis [1]. In our study, the percentage of CNS tuberculosis is considerable and is 6%, followed by Neurocysticercosis which was in 4% of cases.…”

“…A seizure is a common cause for hospitalization of children and results in significant mortality and morbidity [1]. A seizure is a clinical problem that occurs in 10% of pediatric patients [2,3].…”

Low-Field Magnetic Resonance Imaging Findings in Children with Seizures in Ibadan, Nigeria

“…Therefore, imaging is critical to potentially identifying the aetiology of seizure activity and guiding therapy. [9][10][11] This study describes the spectrum of abnormal MRI findings in paediatric seizure disorder using a low-field MRI system and highlights the relative usefulness of this procedure in paediatric seizure imaging, evaluation and management.…”