BACKGROUND Epilepsy is the most common brain disorder during childhood and it may be associated with serious conditions. Early recognition and treatment is essential for best possible outcome. MRI is the modality of choice for investigating epilepsy to detect the underlying aetiology. Different imaging techniques are available that can provide high levels of anatomical and metabolic data. MRI is an important tool in the assessment of children with inborn errors of metabolism.The objective of this study is to study the prevalence of MRI findings and to evaluate the role of MRI in diagnosis and management of childhood epilepsy. The study also aims to compare MRI findings in children having normal neurological examination with those having the specified abnormalities. The clinical and EEG predictors of abnormal MRI were also identified. MATERIALS AND METHODSA total of 80 children between 2 -14 years were admitted with history of seizure (other than symptomatic and febrile seizures) subjected to MRI and EEG were included. Data was obtained from observation and evaluation. Children were also grouped into two to compare MRI findings. The former with abnormal neurological examination and the latter having no neurological abnormalities. MRI and EEG findings were analysed using SPSS software version 18. Settings-Cross-sectional study was conducted in the Department of Paediatrics, Government Medical College, Thrissur, from January -December 2013. RESULTSMean age of the study population was estimated to be 7 years and that of the onset of seizures was 4.15 years. Abnormal MRI findings were found in 39 children (48.75%). 35% of children with normal examination and 62.5% with abnormal examination had abnormal MRI. The age of onset of seizures for children with abnormal MRI was significantly lower than that of those with normal MRI. The most common MRI abnormality detected was Malformations of Cortical Development. 74.3% of children with history of Status Epilepticus had abnormal MRI findings, which were statistically significant. Abnormal EEG was found in 52.5% of the population with 10% showing focal abnormalities. Ten patients (12.5%) were diagnosed with epileptic syndromes. CONCLUSIONMagnetic Resonance Imaging abnormalities are common among epileptic children with abnormal neurological examination. Children with lower age of onset and with status epilepticus showed more abnormalities. MRI helps in the management of children with underlying surgically amenable structural lesions.
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