Abstract
Background
- Seizure is a paroxysmal alteration in neurological function resulting from abnormal excessive cortical neuronal electrical activity.
- Epilepsy is a chronic condition characterised by recurrent seizures
- 5% of children are at risk for epilepsy.
- In order to diagnose the cause of epilepsy various investigations like NSG, XRAY, CT, MRI, EEG are used.
- MRI has emerged as an important tool in detecting etiology of epilepsy.
Objectives
- To detect and characterize various lesions causing epilepsy in pediatric age group(0-12 years).
- To detect the frequency with which they occurred using MRI.
Material and Methods
Type of Study: Prospective hospital based study among 60 paediatric patients presented with epilepsy referred to the Department of Radio diagnosis, King George Hospital, Visakhapatnam.
- All the patients were subjected to MRI using GE 1.5 Tesla.
- Sequences :T1,T2, FLAIR, GRE, Diffusion
- CEMRI,MRS, MRV were included when indicated.
- Lesions were characterized in location, signal intensity using different sequences
Results: In our study, we have found 36 (60%)patients had positive findings on MRI while 24(40%) patients had normal MRI. Among 60 patients, iincidence is more in 7-12 yrs group f/b 1-3 yrs. Among 60 patients, patients with normal MRI are 24(40%), Infectious etiology-13(33.3%), Hypoxic etiology-8(13.3%), Congenital-6(10%), Demyelinating-4(6.6%), Vascular-3(5%), Tumours-2(3.4%)
Discussion: Out of 60 patients, epilepsy incidence is more in 7-12 years(45%) f/b 1-3 years (21.6%), The Male:Female ratio-1.2:1. 36 patients have abnormal findings in our study in which infection is the most common etiology(33.3%) followed by hypoxia(11.6%) .Metabolic causes include least common etiology (1.4%) followed by vascular causes(3.4%)
Conclusion: MRI having high spatial resolution, excellent inherent soft tissue contrast, multiplanar imaging capability and being non radiation modality, emerged as an important tool in imaging of pediatric epilepsy,
MRI can identify, localize and characterize subtle lesions with better spatial and temporal resolution.
MRI thus became the investigation of choice in the evaluation of Pediatric epilepsy.
References
- Coryell J., Gaillard W.D., Shellhaas R.A., Grinspan Z.M., Wirrell E.C., Knupp K.G., Wusthoff C.J., Keator C., Sullivan J.E., Loddenkemper T., et al. Neuroimaging of Early Life Epilepsy. 2018; 142:e20180672. doi: 10.1542/peds.2018-06722
- Anand A, Disawal A, Bathwal P, Bakde A. Magnetic Resonance Imaging Brain in Evaluation of Pediatric Epilepsy. Int J Sci Stud 2017;5(9):8-14.
- Koubeissi M., Azar N. Epilepsy Board Review: A Comprehensive Guide. In: Singh A., Sabharwal P., Shepherd T., editors. Neuroimaging in Epilepsy.Springer; Washington, DC, USA: 2017. pp. 273–291. [Google Scholar]
- Fiest K.M., Sauro K.M., Wiebe S., Patten S.B., Kwon C.S., Dykeman J., Pringsheim T., Lorenzetti D.L., Jetté N. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. 2017;88:296–303. doi: 10.1212/WNL.0000000000003509.
- Almohiy H. Paediatric computed tomography radiation dose: A review of the global dilemma. World J. Radiol. 2014; 6:1–6. doi: 10.4329/wjr.v6.i1.1.
- Chaurasia R, Singh S, Mahur S, Sachan P. Imaging in pediatric epilepsy: Spectrum of abnormalities detected on MRI. J Evol Med Dent Sci 2013;19:3377-87.
- 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;50:37. .
- Kumar PR, Ashok KG, Ghanshyam S, Ghanshyam D. Role of magnetic resonance imaging of brain in paediatric patients with partial seizures. JK Sci J Med Educ Res 2012;14:60-4.
- Kwan P., Arzimanoglou A., Berg A.T., Brodie M.J., Hauser W.A., Mathern G., Moshé S.L., Perucca E., Wiebe S., French J. Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. 2010; 51:1069–1077. doi: 10.1111/j.1528-1167. 2009.02397.
- Gaillard W.D., Chiron C., Cross J.H., Harvey A.S., Kuzniecky R., Hertz-Pannier L., Vezina L.G. ILAE, Committee for Neuroimaging, Subcommittee for Pediatric. Guidelines for imaging infants and children with recent-onset epilepsy. 2009; 50:2147–2153. doi: 10.1111/j.1528-1167.2009.02075.x.
- Scott N. Atlas Magnetic Resonance Imaging of Brain and Spine. 4th ed., Vol. 1. Philadelphia, PA: Lippincott Williams & Wilkins; 2009. p. 307-39.
- Johnston MV. Seizures in childhood. In: Nelson Textbook of Pediatrics. 18th ed., Vol. 2. Philadelphia, PA: Elseveir; 2008. p. 2457.
- Harden C.L., Huff J.S., Schwartz T.H., Dubinsky R.M., Zimmerman R.D., Weinstein S., Foltin J.C., Theodore W.H. Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Reassessment: Neuroimaging in the emergency patient presenting with seizure (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. 2007;69:1772–1880.
- Zajac A, Herman-Sucharska I, Kroczka S, Kubik A, Szczepanik MN. Brain MRI data in children with so called primary generalized seizures. Przegl Lek 2006;64:942-5.
- Wongladarom S, Laothamatas J, Visudtibhan A, Sawatsut P. Magnetic resonance imaging of the brain in epileptic pediatric patients: Review of the experience in ramathibodi hospital. J Med Assoc Thai 2004;87:1092-9.
- Sanghvi JP, Rajadhyaksha SB, Ursekar M. Spectrum of congenital CNS malformations in pediatric epilepsy. Indian Pediatr 2004;41:831-8.
- Gulati P, Jena AN, Tripathi RP, Puri V, Sanchetee PC. MRI (magnetic resonance imaging) spectrum of epilepsy. JIndian Med Assoc 1994;92:110-2.
- Gulati P, Jena A, Tripathi RP, Gupta AK. Magnetic resonance imaging in childhood epilepsy. Indian Pediatr 1991;28:761-5.
Corresponding Author
Dr T. Savitri
Associate Professor, Department of Radiodiagnosis AMC, Visakhapatnam AP
DOI: https://dx.doi.org/10.18535/jmscr/v9i12.12
