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Computed tomography in partial epilepsies in childhood
G Fritsch1, F Ebner, G Schneider
1Department of Pediatrics, University of Graz, Austria.
Insights
Computed tomography (CT) scans in children with partial epilepsy reveal abnormalities in 39%, especially in those with secondary generalized seizures. These findings correlate with neurodevelopmental issues, highlighting CT
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Partial epilepsies are common in children, with varying clinical presentations and underlying etiologies.
- Computed tomography (CT) is a key neuroimaging modality for investigating pediatric epilepsy.
- Understanding the correlation between CT findings and epilepsy characteristics is crucial for diagnosis and management.
Purpose of the Study:
- To analyze CT findings in a cohort of 156 children diagnosed with partial epilepsies.
- To investigate the relationship between CT abnormalities, seizure types, etiology, and neurodevelopmental status.
- To determine the incidence of specific pathological findings, such as atrophic changes and porencephalic lesions.
Main Methods:
- Retrospective analysis of CT investigations performed on 156 children with partial epilepsies.
- Classification of epilepsy based on seizure type (isolated partial, complex partial, secondary generalized).
- Evaluation of CT findings for pathological changes, including atrophic changes and porencephalic lesions.
Main Results:
- Pathological CT findings were present in 39% of the children, with atrophic changes and porencephalic lesions being most common.
- Higher incidence of abnormal CT findings in children with secondary generalized seizures (46%) compared to isolated partial (30%) or complex partial seizures (16%).
- Pathological findings were more frequent in children with perinatal etiology (37%) than familial (26%) or idiopathic (10%) cases.
- Cerebral tumors or vascular lesions accounted for 10% of symptomatic epilepsies.
- A strong correlation was observed between neurodevelopmental disturbances and abnormal CT findings, although 17 neurologically normal children also had abnormal CTs.
Conclusions:
- CT imaging reveals significant pathological findings in a substantial proportion of children with partial epilepsy.
- The type of seizure and perinatal etiology are associated with a higher likelihood of abnormal CT findings.
- Abnormal CT findings strongly correlate with neurodevelopmental disturbances, underscoring the importance of neuroimaging in the comprehensive assessment of pediatric epilepsy.
Abstract:
The CT investigations of 156 children with partial epilepsies are analyzed. Pathological findings appeared in 39%, particularly atrophic changes and porencephalic lesions. According to the seizure type their incidence was higher in children who had secondary generalized seizures (46%) than in children with isolated partial seizures (30%) or complex partial seizures with or without secondary generalization (16%). Furthermore, pathological findings occurred more frequently in children with perinatal etiology (37%) than in familial (26%) or idiopathic cases (10%). A symptomatic epilepsy due to a cerebral tumor or a vascular lesion was found in 10%. There was a high correlation between neurodevelopmental disturbances and abnormal CT findings, however also 17 neurological normal children had pathological CT findings.