Cranial computed tomography in partial motor seizures

Area of Science:

• Pediatric Neurology
• Neuroradiology
• Neuroimaging

Background:

• Partial motor seizures in children can be associated with intracranial structural lesions.
• Developmentally normal children with seizures require accurate diagnosis and appropriate management.
• Computed tomography (CT) is a key imaging modality for evaluating brain lesions.

Purpose of the Study:

• To determine the pattern of intracranial structural lesions in developmentally normal children experiencing partial motor seizures using CT.
• To observe the changes in single ring enhancing lesions (SREL) over time, with or without specific treatments.

Main Methods:

• A cohort of developmentally normal children aged 1-12 years with partial motor seizures were evaluated.
• Clinical examination, investigations for tuberculosis and cysticercosis, and CT scans were performed.
• Children with SREL underwent repeat CT scans after 6 months, with management including anticonvulsants and, if indicated, antitubercular or anticysticercal therapy.

Main Results:

• CT scans showed abnormalities in 68% of children, with SREL being the most common finding (75 children).
• Parietal lobe was the most frequent location for SREL (65 cases).
• In children treated only with antiepileptic drugs, 32 out of 41 with SREL showed a decrease in lesion size on repeat CT, while 9 had no change.

Conclusions:

• Single ring enhancing lesions (SREL) in developmentally normal children with partial motor seizures may resolve spontaneously or with anticonvulsant therapy alone.
• Recognizing the potential for SREL resolution is crucial to prevent unnecessary and potentially harmful antitubercular or anticysticercal treatments.
• Management should prioritize anticonvulsant therapy, reserving specific anti-infective treatments for confirmed cases.