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Role of neuroimaging in children with first unprovoked seizure: A prospective observational study
Manisha Verma1, Chandrakanta Kumar1, Areesha Alam1
1Department of Paediatrics, King George's Medical University, Lucknow, India.
Insights
Neuroimaging reveals significant abnormalities in children experiencing their first unprovoked seizure (FUS), particularly inflammatory granulomas like neurocysticercosis (NCC). Early detection through neuroimaging is crucial for pediatric FUS cases in India.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Epilepsy Research
Background:
- First unprovoked seizure (FUS) is a common neurological presentation in children.
- Neuroimaging plays a vital role in identifying underlying causes of seizures.
- Understanding the spectrum of neuroimaging findings in FUS is essential for diagnosis and management.
Purpose of the Study:
- To determine the incidence and types of neuroimaging abnormalities in children with FUS.
- To explore the correlation between neuroimaging findings and clinical characteristics in pediatric FUS.
Main Methods:
- A prospective observational study conducted in Northern India.
- Enrolled 115 children aged 6 months to 14 years with FUS.
- Neuroimaging was performed, and factors associated with abnormalities were statistically analyzed.
Main Results:
- 34.8% of children with FUS showed abnormal neuroimaging findings.
- Inflammatory granulomas, including neurocysticercosis (NCC), were the most frequent abnormality (70%).
- Abnormalities were associated with age, seizure type (focal vs. generalized), perinatal asphyxia, and developmental delay.
Conclusions:
- A high prevalence of neuroimaging abnormalities exists in pediatric FUS, with NCC being a significant cause.
- Neuroimaging is strongly recommended for all children presenting with FUS in India due to the high incidence of treatable causes.
- Findings emphasize the importance of neuroimaging in the etiological diagnosis of FUS in this population.
Objective:
To evaluate the incidence and type of neuroimaging abnormalities in first unprovoked seizure (FUS) in children. To investigate the association of neuroimaging abnormalities with clinical variables.
Methods:
A prospective observational study enrolled children aged 6 months-14 years with FUS over one year at a tertiary-care teaching hospital, Northern India and subjected them to neuroimaging. Factors associated with abnormal neuroimaging were assessed using Chi square/Fischer Exact test.
Results:
Out of 115 cases, 40 (34.8%) had abnormal neuroimaging. Frequent findings were inflammatory granuloma (70%) including Neurocysticercosis (NCC) (40%), ill-defined granuloma, calcified nodule and tuberculoma followed by white matter signal alterations. Inflammatory granuloma was significantly associated with age >2 years and focal seizures. Calcified nodule was more common in children >10 years. Other neuro-abnormalities like cerebral atrophy, gliosis, infarcts, and white matter changes were significantly prevalent with generalized seizures, perinatal asphyxia, and developmental delay.
Conclusion:
High prevalence of abnormalities in FUS, especially focal seizures, due to NCC warrants neuroimaging in all children with FUS in India.
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