Yapici Ozge, Uzunhan Tugce Aksu
Department of Radiology, Marmara University Faculty of Medicine, Pendik Training and Research Hospital, Istanbul, Turkiye.
Department of Child Neurology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkiye.
North Clin Istanb. 2024 Feb 1;11(1):72-80. doi: 10.14744/nci.2023.39581. eCollection 2024.
The aim of this study was to investigate cranial magnetic resonance imaging (MRI) findings in different age groups and genders in pediatric epilepsy, to determine the percentages of etiologic factors, and to evaluate the association between MRI positivity and treatment resistance.
Cranial MRIs of 359 patients with epilepsy aged 1 month to 18 years were retrospectively evaluated. Etiologic factors as an underlying cause of epilepsy were classified as previous parenchymal damage, hippocampal sclerosis, malformations of cortical development, tumor, neurocutaneous syndrome, myelination disorder, vascular anomaly, metabolic/genetic/neurodegenerative diseases, encephalitis, and an uncategorized "other" group. Data were transferred to IBM SPSS Statistics 25.0 (SPSS Inc., Chicago, IL, USA), and descriptive statistics, correlation analyses, chi-square, and t-tests were performed.
Among the patients included in the study, 141 (39.3%) had pathological findings on MRI related to the etiology. Previous parenchymal damage (39.7%) was the most common etiologic cause in all age groups. Regarding the relationship between drug resistance and MRI positivity, MRI positivity was observed in 72% of drug-resistant cases, while a complete response to therapy was found in 67.6% of MRI-negative cases.
MRI guides clinicians to determine the presence of an etiologic factor as the underlying cause of childhood epilepsy before treatment planning. MRI positivity is a remarkable indicator of response to antiseizure drug treatment and drug resistance.
本研究旨在调查小儿癫痫不同年龄组和性别的头颅磁共振成像（MRI）表现，确定病因因素的百分比，并评估MRI阳性与治疗抵抗之间的关联。
回顾性评估359例年龄在1个月至18岁之间的癫痫患者的头颅MRI。作为癫痫潜在病因的病因因素分为既往实质损伤、海马硬化、皮质发育畸形、肿瘤、神经皮肤综合征、髓鞘形成障碍、血管异常、代谢/遗传/神经退行性疾病、脑炎以及未分类的“其他”组。数据被传输到IBM SPSS Statistics 25.0（美国伊利诺伊州芝加哥市SPSS公司），并进行描述性统计、相关性分析、卡方检验和t检验。
在纳入研究的患者中，141例（39.3%）MRI有与病因相关的病理表现。既往实质损伤（39.7%）是所有年龄组中最常见的病因。关于耐药性与MRI阳性之间的关系，在72%的耐药病例中观察到MRI阳性，而在67.6%的MRI阴性病例中发现对治疗有完全反应。
MRI指导临床医生在制定治疗计划前确定病因因素作为儿童癫痫的潜在病因。MRI阳性是对抗癫痫药物治疗反应和耐药性的显著指标。
