IMAGING IN PEDIATRIC EPILEPSY: SPECTRUM OF ABNORMALITIES DETECTED ON MRI
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2013, Vol 2, Issue 19
Abstract
[b] OBJECTIVE[/b]: To evaluate role of radio-imaging, with emphasis on MRI in comparison to other modalities, in patients of paediatric age group presenting with epilepsy and correlate it with clinical findings in Bundelkhand region. [b]METHODS[/b]: Prospective data was obtained from evaluation of patients presenting with epilepsy in paediatric OPD and IPD, between 2010 and 2012. A total of 271 patients presenting with epilepsy (> 2 episodes of seizures) were included. CBC, Chest X-ray and CSF analysis were also performed for clinical evaluation as per need. Neurosonogram was done in 41 children below age of 1year (15.1%), Head CT was obtained in 167 (61.7%), MRI in all cases. EEG was done in all cases, except in 5 cases of trauma. Epilepsy provoked by causes such as fever, electrolyte imbalance and dehydration were excluded. [b]RESULTS[/b]: We observed that generalized seizures were more common presentation, followed by partial seizures, mostly complex. Majority had more than 2 episodes of seizures at the time of presentation. MRI revealed positive findings in 191 cases (70.4%) and CT in 64 cases (38.3%) of 167 done. MRI had positive findings in 35 cases (34.0%) of 103 with normal CT scan. Most common cause of epilepsy in this region was found to be CNS tuberculosis (Tuberculomas, 15.7% & TBM, 14.6%), followed by Neurocysticercosis (11.0%), Encephalitis (7.9%), Demyelination (6.8%), Gliosis with or without Encephalomalacia (6.8%), Periventricular leukomalacia (5.2%), Infarct (4.7%) & porencephaly (3.7%). Rare causes observed were leukodystrophy (7cases), intra-axial bleed (4 case) and extra-axial bleed (5case), heterotopias (4 case), abscess (2case) and Phakomatosis (Tuberous Sclerosis, 1 case). [b]CONCLUSION[/b]: Since most of the seizures begin in paediatric age-group, which is crucial time for physical, psychosocial & mental growth, it is essential to evaluate the diverse varieties of aetiologies and manage patient accordingly. MRI thus proves to be the best for almost all pathologies, causing epilepsy, except trauma.
Authors and Affiliations
Rachna Chaurasia, Shuchi Singh, Sachin Mahur, Pankaj Sachan
Keywords
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- EP ID EP122656
- DOI 10.14260/jemds/707
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