MRI Findings and Diagnostic Yield in Pediatric Epilepsy: A Cross-Sectional Study

This study evaluates the diagnostic utility of magnetic resonance imaging (MRI) in pediatric epilepsy by analyzing the distribution of structural abnormalities and comparing the sensitivity and diagnostic yield of MRI in generalized versus partial seizures.

A total of 270 pediatric epilepsy patients (mean age: 8.5 years; 60% male) were included in this cross-sectional study. MRI findings were categorized into specific etiologies, including gliosis, infectious causes, vascular disease, tumors, congenital malformations, and others. MRI sensitivity and diagnostic yield were compared between patients with generalized and partial seizures. The study adhered to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for observational research.

MRI abnormalities were identified in 73% of patients, with the most common findings being gliosis (14%), infectious causes (13%), and vascular disease (11.6%). Other notable etiologies included tumors (9.3%), congenital malformations (9.3%), phakomatosis (7%), encephalitis (7%), mesial temporal sclerosis (5%), leukodystrophy (4%), and vascular malformations (2.5%). MRI sensitivity was higher in partial seizures (70%) compared to generalized seizures (40%). Similarly, the diagnostic yield of MRI was significantly greater for partial seizures (72%) than for generalized seizures (40%).

MRI is a valuable imaging modality for identifying structural abnormalities in pediatric epilepsy, with a higher diagnostic yield in patients with partial seizures. The findings underscore the importance of high-resolution MRI protocols in evaluating epilepsy, particularly in children with focal seizure presentations. Future studies should explore the integration of advanced imaging techniques to further enhance diagnostic accuracy.