[A link between congenital malformations of the central nervous system and epilepsy in paediatric patients in Mexico]
E Alva-Moncayo1, A J Horta-Martínez, M Castro-Tarín
1Servicio de Neurología Pediátrica, Hospital General Médico Nacional La Raza, México DF, Mexico. edith58@prodigy.net.mx
Insights
Congenital malformations of the central nervous system are a primary cause of childhood epilepsy. Magnetic resonance imaging is the most effective diagnostic tool for identifying these conditions.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Epileptology
Context:
- Epilepsy is a frequent neurological condition in children.
- Congenital malformations represent the second leading cause of pediatric epilepsy.
- Understanding neurodevelopmental origins is crucial for epilepsy management.
Purpose:
- To identify and classify congenital malformations associated with pediatric epilepsy.
- To correlate specific malformations with epilepsy syndromes and seizure types.
- To evaluate the utility of neuroimaging in diagnosing these conditions.
Summary:
- A study of 116 pediatric epilepsy patients with central nervous system congenital malformations was conducted.
- Malformations were categorized based on neurodevelopmental timing, with migration disorders (e.g., lissencephaly) and proliferation disorders being prominent.
- Commonly associated epilepsy syndromes included West and Lennox-Gastaut syndrome, with partial seizures being frequent.
Impact:
- Highlights congenital malformations as a key etiology of pediatric epilepsy.
- Emphasizes magnetic resonance imaging (MRI) as the superior neuroimaging modality for diagnosis.
- Suggests MRI for unexplained epilepsy cases to refine diagnosis and inform treatment strategies.
Introduction:
Since epilepsy is one of the most frequent causes of visits in Paediatric Neurology, attention must be given to one of the causes linked to it, namely congenital malformation, which is the second most common cause of epilepsy. To this end, different forms of congenital defects related to epilepsy in Paediatric medicine can be identified according to their neurodevelopment.
Aims:
The purpose of this study was to determine the different congenital malformations associated to epilepsy in Paediatrics.
Patients And Methods:
We took a sample consisting of 116 patients diagnosed as suffering from epilepsy associated with congenital malformations of the central nervous system, following an evaluation of imaging studies, magnetic resonance and computerised tomography brain scans; subjects were then grouped according to the normal embryonic chronological development of the human being.
Results:
From the total number of cases, a selection was made according to age, where the predominant group was found in those below one year of age and in the group of school-age children, and migration disorders, where the main malformation included was lissencephaly; the other group was made up of proliferation disorders. Similarly, the associated types of epilepsy were the most common childhood epileptic syndromes, West and Lennox-Gastaut syndrome. The types of epileptic seizures that were found were partial seizures.
Conclusions:
The study outlined above shows congenital malformations of the central nervous system to be the main cause associated to epilepsy and the most sensitive neuroimaging study currently available is magnetic resonance. For this reason we suggest the use of this procedure in cases in which no apparent cause can be found so that this nosological entity can be defined to a greater degree of precision. Despite its multifactorial causation, being below 25 years of age and above 35 at the time of pregnancy is considered to constitute a higher potential risk, while no geographic location was found to predominate.
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