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Published on: September 20, 2024
Magnetic resonance imaging abnormalities in children with epilepsy
T Durá-Travé1, M E Yoldi-Petri, J Esparza-Estaún
1Neurology Pediatric Unit, Navarra Hospital Complex, Pamplona Department of Neuroradiology, Navarra Hospital Complex, Pamplona, Spain. tduratra@cfnavarra.es
Insights
Pediatric epilepsy diagnosis reveals significant magnetic resonance imaging (MRI) abnormalities in over 20% of children. These findings, including white matter lesions, impact epilepsy classification and management guidelines.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Epileptology
Background:
- Epilepsy is a common neurological disorder in children.
- Understanding the underlying causes and imaging findings is crucial for diagnosis and management.
- Magnetic resonance imaging (MRI) is a key tool in evaluating pediatric epilepsy.
Purpose of the Study:
- To analyze the distribution of epilepsy types and syndromes in children.
- To describe the magnetic resonance imaging (MRI) abnormalities in pediatric epilepsy patients.
- To correlate MRI findings with epilepsy classification.
Main Methods:
- Retrospective analysis of 457 children (1 month to 15 years) diagnosed with epilepsy.
- Standardized pediatric seizure MRI protocol used for all patients.
- Classification of MRI abnormalities using a standardized scoring system and International League Against Epilepsy criteria.
Main Results:
- Significant MRI abnormalities were found in 21.9% of children with epilepsy.
- Prevalence of abnormalities was highest in infants (42.3%) and lower in childhood (18.2%) and adolescence (15.9%).
- Common MRI findings included white-matter lesions (27.6%), volume loss (19.6%), gray-matter lesions (19.6%), and ventricular enlargement (12%).
Conclusions:
- Routine MRI with a standardized scoring system identifies a high rate of significant abnormalities in pediatric epilepsy.
- These findings have potential implications for refining clinical practice guidelines in pediatric epilepsy management.
- Early identification of MRI abnormalities can aid in epilepsy syndrome classification and treatment planning.
Background And Purpose:
The aim of this study is to analyze the proportional distribution of epilepsy and epileptic syndromes in children and to describe the magnetic resonance imaging (MRI) abnormalities found in these patients.
Methods:
Data from 457 children aged 1 month to 15 years at the time of diagnosis of epilepsy were recorded. A routine MRI has been requested in all patients with epilepsy at diagnosis according to a standardized pediatric seizure protocol. Abnormalities on MRI were classified as either significant or non-significant (standardized scoring system). International League Against Epilepsy criteria were used for diagnoses.
Results:
The prevalence of significant MRI abnormalities was 21.9% (in infants 42.3%, in childhood 18.2%, and in adolescents 15.9%). The most common abnormalities included white-matter lesions (27.6%), volume loss (19.6%), gray-matter lesions (19.6%), and ventricular enlargement (12%).
Conclusions:
The use of MRI and a reliable standardized scoring system at diagnosis of epilepsy in children identified a high rate of significant abnormalities findings. This may have important implications for practice guidelines in this population.
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