A RETROSPECTIVE STUDY ON PATTERNS OF BRAIN MRI FINDINGS IN PATIENTS WITH PEDIATRIC EPILEPSY SEEN IN THE RADIOLOGY DEPARTMENT AT SPHMMC, ADDIS ABABA, ETHIOPIA

Abstract

ABSTRACT Background: Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures. It can result from inherited (genetic) or acquired factors or a combination of both. Important causes include infections, head trauma, vascular malformations, brain tumors and stroke. MRI can diagnose these wide varieties of pathologic lesions routinely and noninvasively. Objective: The objective of this study was to assess the patterns of brain MRI findings in pediatric epilepsy patients in SPHMMC Method: A retrospective cross-sectional study was conducted at SPHMMC among pediatric epilepsy patients evaluated at radiology department from March 2018 to August 2019 G.C. All patients who fulfill the International League Against Epilepsy (ILEA) criteria of epilepsy and who had brain imaging done on a 1.5T MRI machine with standard epilepsy protocol were included in this study. Data was collected by using structured data collection format, analyzed using SPSS version 20.0 software and results was displayed using descriptive statistics. The total budget required for the study was 25,443 birr. Results: A total of 243 patients had brain MRI done at the radiology unit for the clinical indication of seizure during the study period. Among whom 162 patients who had at least one epileptic seizure, who had their brain MRI done on standard epilepsy protocol and whose charts were retrievable were included in this study. Out of the included patients 90(55.6%) were male, 72 (44.4%) were female, 58 (35.8%) were in the 0-6 years age group, 15(9.5%) were between 6 and 12 years of age and more than half of all patients (55%) were aged between 12 and 18years. The commonest type of seizure reported in this study was generalized tonic clonic seizure (GTC) accounting for 87 (53.7%) of the cases and 74(45.7%) of the patients had their first seizure between the age of 12-18 while 68(42%) had their first seizure before 6 years of age. Abnormalities were detected on the brain MRI in about 56 (34.6%) of the cases. The commonest brain abnormality detected in this study was gliosis/brain parenchymal volume loss which was seen in 30 (53.6%) of the cases. The other abnormalities seen include developmental cortical malformation 6 (10.7%) , mesial temporal sclerosis 4(7.1%) and brain tumor 3(5.4%). The commonest cause of gliotic change identified was perinatal injury 12(41.4%) and 18(62%) of the gliotic lesions were seen among children aged less than 10 years. Conclusion: In this study, children aged between 12 and 18 years were more affected by epilepsy where GTC was the commonest seizure type. Gliosis or brain parenchymal volume loss predominantly caused by perinatal injury was the commonest type of brain abnormality. The other lesions identified included developmental cortical malformations, mesial temporal sclerosis, brain tumors and infections. Key words: Seizure, Epilepsy, SPMMC, MRI, Gliosis, Perinatal injury