Spectrum of Magnetic Resonance imaging in Afebrile Pediatric Epilepsy

Abstract

Background: Pediatric neurological disorders are commonly encountered. Epilepsy is one of the most common neurological disorder in childhood. Clinically diagnosis is established by two or more unprovoked seizures at least 24 hours apart. It has got considerable importance due to fact that it can cause anxiety in parents. Cortical malformations characterized by abnormal structure of cerebral cortex are one of the major cause for epilepsy. Magnetic resonance imaging is the modality of choice to evaluate the structural anomaly, the cause of seizure disorder and to assess the potential need for surgery. In this study, we tried to evaluate the spectrum of MRI imaging to evaluate afebrile pediatric epilepsy. Subjects and Methods: The study was retrospective cross sectional study. We collected data of 400 patients of pediatric epilepsy who underwent non contrast MRI evaluation during June 2017 to January 2019 at department of Radio-diagnosis at GCS Medical college, Hospital and Research Center. Exclusion criteria consist of a recent history of fever and clinical laboratory parameters of any infective cause. MRI was done using 1.5 Tesla equipment. Sequences included Sagittal T1-weighted spin echo (SE), Axial T2-weighted fast spin echo (FSE), Coronal oblique fast fluid attenuated inversion recovery (FLAIR), Axial diffusion weighted single-shot spin-echo echoplanar, Axial 3D inversion recovery prepped fast SPGR (spoiled gradient recalled). Results: The most common detected changes were unilateral and bilateral mesial temporal sclerosis (21% & 9% respectively), cortical dysplasia (1.5%), migrational anomalies, neurocutaneous syndromes and few cortical neoplasms (0.5 to 1%). Conclusion: MRI in today's world plays a deciding role in diagnostic work-up of a child with epilepsy.