Role of Magnetic Resonance Imaging of Brain in Evaluation of Pediatric Seizure Disorder

BS Soujanya; KM Dhrithiman Shetty; Uppoor Raghuraj; Vijaya Shenoy

doi:10.18502/acta.v60i4.9265

BS Soujanya Department of Paediatrics, K.S Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore–575018, India
KM Dhrithiman Shetty Department of Paediatrics, K.S Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore–575018, India
Uppoor Raghuraj Department of Radiology, K.S Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore–575018, India
Vijaya Shenoy Department of Paediatrics, K.S Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore–575018, India

DOI: https://doi.org/10.18502/acta.v60i4.9265

Keywords: Magnetic resonance imaging; Magnetic resonance imaging (MRI); Seizure disorder; Epilepsy; Gliosis; Electroencephalogram; Electroencephalogram (EEG)

Abstract

Seizure disorder in children is commonly seen in clinical practice and in the assessment of these patients. Magnetic Resonance Imaging (MRI) is found to be the ideal and first imaging modality of choice for pediatric seizure disorder because of lack of radiation exposure. This work aims to assess the role of MRI of the brain in the evaluation of pediatric seizure disorder. Before undergoing MRI, all of the patients received EEG to detect the epileptogenic center. On the superconductive 1.5-Tesla Siemens Avanto Magnetom MR system, patients underwent a brain MRI scan. Percentages and proportions were used in the statistical analysis. Around 70% of children with seizures were found to be controlled by the use of a single antiepileptic drug (AED). Electroencephalogram (EEG) findings were abnormal in 82% of patients. The MRI findings were normal in 45 patients (45%) and abnormal in 55 patients (55%). The common abnormalities were gliosis (45.4%), periventricular leukomalacia (12.7%), neurodegenerative changes in white/grey matter (7.3%), focal cortical dysplasia (FCD) (7.3%), arteriovenous malformations (AVM) (7.3%), polymicrogyria (5.5%), mesial temporal sclerosis (MTS) (5.5%), abnormal spectroscopy (3.6%), space-occupying lesion (SOL) (3.6%) and megalencephaly (1.8%). Our study showed about 55% of children with seizures had MRI abnormalities and common abnormalities were gliosis and periventricular leukomalacia. Improvements in perinatal care, hygiene, and socio-economic status can help in reducing the incidence and thus morbidity associated with a seizure disorder. Thus, MRI plays a pivotal role in the workup of pediatric patients with a seizure disorder.