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Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
Published on: September 20, 2024
Age-specific MRI patterns in pediatric epilepsy: insights from a sudanese cohort and implications for low-resources
Yousif Mohamed1, Abubaker Babiker2, Hind Elamin3
1Facutly of Medicine, University of Khartoum, Khartoum, Sudan. Valyvxly@gmail.com.
Insights
Magnetic Resonance Imaging (MRI) reveals abnormalities in one-third of pediatric epilepsy cases in Sudan, with findings varying by age. Prioritizing neuroimaging for infants and adolescents can improve diagnosis and resource allocation in low-income settings.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Global Health
Background:
- Epilepsy significantly impacts children's quality of life globally.
- Neuroimaging, especially MRI, is vital for identifying epilepsy causes.
- Optimizing diagnostic yield in low-resource settings is crucial for pediatric epilepsy management.
Purpose of the Study:
- To assess the diagnostic value of MRI in Sudanese pediatric epilepsy patients.
- To identify age-specific patterns in neuroimaging findings.
- To inform resource allocation for epilepsy diagnosis in low-income countries.
Main Methods:
- A cross-sectional study included 100 pediatric epilepsy patients (≤17 years).
- Data collected included age, gender, and MRI findings.
- Statistical analysis involved Chi-square tests and logistic regression.
Main Results:
- 31% of patients had abnormal MRI findings; mesial temporal sclerosis was most common.
- Abnormalities were significantly associated with age (P=0.002), particularly in infants (<1 year) and adolescents (13-17 years).
- Specific findings like periventricular leukomalacia, atrophy, mesial temporal sclerosis, and tumors showed age-related prevalence.
Conclusions:
- MRI detects abnormalities in a substantial portion of pediatric epilepsy cases.
- Age is a key factor influencing MRI findings in pediatric epilepsy.
- Age-specific MRI protocols and targeted neuroimaging in infants and adolescents can enhance diagnostic efficiency in resource-limited settings.
Objective:
Epilepsy is a global health problem affecting the quality of life of many children. Neuroimaging, particularly Magnetic Resonance Imaging (MRI), plays a crucial role in precisely identifying epileptogenic foci that are potentially amenable to surgical resection for a possible cure. This study aims to evaluate the diagnostic yield of MRI in a Sudanese pediatric epilepsy cohort and to identify age-specific neuroimaging patterns to optimize resource allocation in low-income settings.
Methods:
A descriptive cross-sectional study enrolled 100 pediatric patients (≤ 17 years) diagnosed with epilepsy from June 2023 to June 2024. Data on age, gender, and MRI findings were collected and analyzed using SPSS v26.0. Chi-square tests assessed univariate associations, and multivariate logistic regression evaluated the combined impact of age and gender on abnormal MRI findings, with significance set at P < 0.05.
Results:
Of 100 patients (55% male, 45% female), 87% were aged 1-12 years. MRI abnormalities were detected in 31%, with mesial temporal sclerosis (35.4%) most frequent, followed by brain atrophy and periventricular leukomalacia (16% each). Age was significantly associated with abnormalities (P = 0.002), with higher odds in < 1-year-olds (OR = 9.35, 95% CI: 1.67-52.41, P = 0.011) and 13-17-year-olds (OR = 14.20, 95% CI: 1.47-137.32, P = 0.021) compared to 1-6-year-olds. Specific findings varied by age: periventricular leukomalacia in < 1-year-olds, atrophy in 1-6 years, mesial temporal sclerosis in 7-12 years, and tumors in 13-17 years (P < 0.002). Gender showed no significant effect (OR = 0.74, 95% CI: 0.32-1.71, P = 0.480).
Conclusion:
Approximately one-third of children with epilepsy showed MRI abnormalities, most commonly mesial temporal sclerosis. Abnormal MRI results were notably linked to patient age, particularly those under one year old and between 13 and 17 years old. Age-specific MRI protocols could enhance diagnostic efficiency in low-resources settings. These findings support for prioritized neuroimaging in infants and adolescents, informing public health strategies to address Sudan's epilepsy burden.
Clinical Trial Number:
Not applicable.
