[Brain MRI data in children with so called primary generalized seizures].

INTRODUCTION

Diagnosis of primary generalised seizures may be not precise because difficulties exist with the assessment of information of focal onset of these seizures.

THE AIM

The aim was to examine if the careful searching for partial component of seizures is necessary in children with so called primary generalized seizures.

MATERIAL AND METHODS

The examined group included 45 children aged 6 month to 18 year (mean 11 year) within 19 girls and 26 boys, hospitalized during the year 2006 in the Department of Pediatric Neurology UJ CM in Krakow. The history indicated the primary generalized character of seizures. The tonic-clonic seizures were observed in 39 children, myoclonic in 3, infantile spasms in 1 and absence in other 2. In 6 patients familiar epilepsy was diagnosed in first-degree cousins. Neuropediatric examination was normal apart from 4 children with dysmorphic features of the face. Intellectual development was normal in 43 children, however it was close to the lower range in one and mildly delayed in the other one. Generalized paroxysmal bioelectric activity was detected in 43 children and in 2 children EEG pattern was normal. MRI was performed in SE T1, FSE T2, PD, FLAIR and IR T1 sequences with 3 or 5 millimetre thickness of layer in the sagital, coronal and transversal plane, using a 1.5 T signa horizon HiSpeed General Electric. These examinations were performed in the Voxel MR Laboratory in University Children's Hospital in Krakow.

RESULTS

MRI results were normal in 14/45 children and in others pathological. In 9/45 MR revealed subarachnoidal cyst, in 8 lateral ventricles asymmetry, in 5 mild demyelination, in 9 subarachnoid space and lateral ventricles dilatation. In 2/45 children brain tumors (hamartoma of the hypothalamus and DNET of the temporal lobe), in 1 gliosis of the occipital lobe were revealed, however other insignificant changes were also observed. Dual or multiple MRI pathology was revealed in 14 children. In17/45 children abnormalities were localized.

CONCLUSIONS

Existence of focal pathology in MRI of 38% children with the history of so called primary generalized seizures suggested the necessity of more careful searching for partial component of seizures.