Neuroimaging findings in first unprovoked seizures: a multicentric study in tehran

Area of Science:

• Pediatric Neurology
• Neuroimaging
• Epilepsy Research

Background:

• First unprovoked seizures (FUS) are critical pediatric emergencies requiring thorough investigation.
• Understanding the etiology of FUS is essential for accurate diagnosis and prognosis.
• Advancements in diagnostic techniques necessitate re-evaluation of imaging findings in FUS.

Purpose of the Study:

• To evaluate brain imaging findings in pediatric patients with first unprovoked seizures (FUS).
• To compare the diagnostic yield of different neuroimaging modalities in FUS.
• To identify potential associations between imaging abnormalities and seizure characteristics.

Main Methods:

• A study involving 96 children with FUS admitted to three major pediatric hospitals.
• Brain imaging (CT or MRI) was performed based on patient's clinical and financial status.
• Expert pediatric neuroimaging radiologists interpreted all imaging studies.

Main Results:

• Abnormal findings were present in 27.1% of all patients.
• MRI detected abnormalities in 29.2% of cases, while CT identified them in 14.3%.
• Common abnormalities included gliosis, hemorrhage, dysgenesis, dysmyelination, encephalomalacy, atrophy, and infarction. No association was found between seizure duration/age and imaging abnormalities, but lesion location correlated with seizure type.

Conclusions:

• Brain imaging is recommended for all pediatric patients presenting with FUS.
• Brain MRI is generally superior to CT for detecting abnormalities in FUS patients.
• Further research may refine the role of neuroimaging in the etiological diagnosis of FUS.