Evaluation of Non Febrile Seizure Disorder on MRI with Correlation with Seizure Type and EEG Records in Children.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 17, Issue 2
Abstract
Objectives: The aim of this retrospective study was to investigate the spectrum of abnormality on MRI, to correlate MRI findings with the seizure type and EEG findings wherever available in children presenting with non febrile seizure disorder. Patients and Methods: A retrospective hospital based study was done of 271 children who underwent brain MRI for seizure disorder with exclusion of febrile conditions, recent trauma and metabolic conditions from the study. The MRI findings were interpreted independently and subsequently correlated with clinical history and EEG findings wherever available from patients’ records. Results: More than half of the patients (53%) were in the age group of 11-15 years. Generalised seizures were the most common seizure pattern in all age groups. Out of the 271 children included in the study, 106(39%) had abnormal cranial MRI scans. The most common abnormality detected on MRI was granulomatous lesion in 56 cases (33.3%), followed by periventricular leukomalacia/hypoxic ischemic encephalopathy in 12 cases (7.1%) , focal gliotic and encephalomalacic changes in 9 cases (5.4%), congenital/developmental anomalies including leukodystrohies in 8 cases(4.8%), mesial temporal sclerosis in 5 cases(3%), hydrocephalous in 4 cases(2.4%), and demyelinating conditions in 3 cases(2%), while tumors (2 cases), cerebral atrophy (2 cases), vascular malformations (2 cases), non traumatic intracranial bleed (2 cases)and cerebral venous thrombosis (1 case) comprised the rest of the causes. Children with unclassified and partial seizures had high rate of abnormality detection on MRI, while those with primary generalized seizures had relatively lower rate of abnormality detection on MRI. Interictal awake scalp EEG findings were available in 100(37%) cases. There was moderate positive correlation between abnormality detection on EEG and MRI(Pearson correlation coefficient,r=0.65). Conclusions: This study shows that CNS granulomatous pathology andhypoxic ischemic encephalopathy were the two most common abnormalities detected on MRI and primary generalized seizures were the most common presentation in children presenting with non febrile seizures. Prior knowledge of seizure type and EEG records can be helpful factors in increasing diagnostic efficacy of MRI and avoiding unnecessary imaging.
Authors and Affiliations
Dr. Sameer R. Verma, Dr. Vandana Sardana
Keywords
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- EP ID EP363841
- DOI 10.9790/0853-1702130912
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