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Magnetic resonance imaging findings in children with a first recognized seizure

Andrew J Kalnin1, Philip S Fastenau, Ton J deGrauw

  • 1Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana.

Pediatric Neurology
|November 26, 2008
PubMed

Insights

Magnetic resonance imaging (MRI) revealed structural abnormalities in 31% of children experiencing their first seizure. A standardized scoring system identified more significant findings, suggesting revised practice parameters for pediatric seizure diagnosis.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Epileptology

Background:

  • Pediatric seizures are a common neurological concern.
  • Identifying underlying structural causes is crucial for diagnosis and management.
  • Previous studies may have underestimated the prevalence of MRI abnormalities in new-onset pediatric seizures.

Purpose of the Study:

  • To characterize structural abnormalities in children with new-onset seizures using magnetic resonance imaging (MRI).
  • To assess the utility of a standardized MRI scoring system in a prospective pediatric cohort.
  • To determine the frequency and types of MRI findings associated with first recognized seizures in children.

Main Methods:

  • A prospective cohort of 281 children (aged 6-14 years) underwent MRI within 6 months of their first seizure.
  • Standardized seizure MRI protocols and a validated scoring system were employed.
  • Abnormalities were classified and their potential relation to seizures evaluated.

Main Results:

  • MRI identified at least one abnormality in 31% (87/281) of children; 12% (34/281) had two or more.
  • Common abnormalities included ventricular enlargement (51%), leukomalacia/gliosis (23%), and gray-matter lesions (12%).
  • Significant or potentially seizure-related abnormalities were found in 14% (40/281), with increased detection of temporal lobe/hippocampal abnormalities.

Conclusions:

  • Standardized MRI protocols and scoring systems reveal a higher incidence of structural abnormalities in children with new-onset seizures than previously reported.
  • Findings suggest that current practice parameters may need revision to broaden the definition of significant abnormalities.
  • Wider utilization of MRI in pediatric epilepsy diagnosis is supported by these findings.

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