Magnetic resonance imaging of the brain in epileptic pediatric patients: review of the experience in Ramathibodi Hospital.

OBJECTIVE

To review a series of epileptic children referred for MR imaging and correlate the structural abnormalities from the MRI findings with clinical data and EEG.

MATERIAL AND METHOD

Retrospective review of MRI of the brain performed in children, aged less than 15 years with epilepsy at Ramathibodi Hospital from January 1999 to December 2002 was done. There were 100 children (57 girls, 43 boys) with epilepsy, age range from one month to 14 years, mean 7 years and 5 months. Diagnosis of seizure type and epilepsy were classified according to clinical presentation and EEG.

RESULTS

There were 16 children with primary generalized seizure, 79 children with partial or complex partial seizures with or without secondary generalization. The remaining 5 children had a specific syndrome. The most common etiology of all patients was congenital disease, especially cortical dysplasia. Among children with partial with or without generalization, cortical dysplasia was the most common finding (31%). Mesial temporal sclerosis and combined cortical dysplasia with mesial temporal sclerosis were found in 24% and 13.9%, respectively. Most of the disease categories showed significant concordance of the EEG to the MRI findings, except infectious disease.

CONCLUSION

The most common etiology of epilepsy in children under 15 years old was cortical dysplasia. For children with partial or complex partial seizure, cortical dysplasia was the most common etiology followed by mesial temporal sclerosis and combined cortical dysplasia with mesial temporal sclerosis, respectively. MRI provides precise etiologic classifications of epilepsy.