Magnetic Resonance Imaging findings in pediatric patients with Epilepsy: a single-center experience from Pakistan
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Abstract
OBJECTIVE: To determine the structural abnormalities on magnetic resonance imaging (MRI) in the epileptic Pakistani pediatric population presenting at Tertiary Care Hospital, Karachi.
METHODS: This cross-sectional descriptive study was done at the CT & MRI Center, Dr Ruth K.M Pfau Civil Hospital Karachi, from February 2019 to January 2020. This study enrolled 173 subjects of either gender between 1-14 years of age with epilepsy who underwent an MRI of the brain. An MRI brain with epilepsy protocol was performed after taking a history from each patient. Abnormalities were reported according to their imaging features, signal intensity, and location.
RESULTS: Of the 173 subjects, 94 (54.3%) were boys and 79 (45.7%) were girls, with mean age of 6.7±3.3 years. Generalized seizures were predominant (n=103; 59.5%), followed by focal seizures (n=57; 33%), and unknown seizure patterns (n=13; 7.5%). MRI findings were unremarkable in 68 (39.3%) cases, predominantly in both generalized (35.84%) and focal (2.31%) epilepsy cases. Structural abnormalities were evident in 105 (60.7%) patients on MRI. Cerebral atrophy was predominant (11.56%), especially in generalized epilepsy cases. Encephalomalacia (6.94%) and ventricular enlargement (6.36%) were observed, with encephalomalacia more prevalent in focal epilepsy and ventricular enlargement in generalized epilepsy. Mesial temporal sclerosis (5.7%) was significant in focal epilepsy cases. The highest prevalence of unremarkable MRI findings was in the 6-10 years’ age group (20.2%).
CONCLUSION: MRI detected abnormalities in 60.7% cases of paediatric epilepsy, most commonly cerebral atrophy and encephalomalacia, emphasizing MRI's role in assessing epilepsy-related structural changes and the need for targeted interventions.
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