Brain magnetic resonance imaging findings among children with epilepsy in two urban hospital settings, Kampala-Uganda: a descriptive study

Abstract

Background Epilepsy is one of the most common neurological conditions in children worldwide. Its presentation is heterogeneous, with diverse underlying aetiology, clinical presentation, and prognosis. Structural brain abnormalities are among the recognized causes of epilepsy. Brain Magnetic Resonance Imaging (MRI) is the imaging modality of choice for epilepsy workup. We aimed to determine the prevalence and describe the structural abnormalities identified in the brain MRI studies performed on children with epilepsy from two urban hospitals in Kampala, Uganda. Methods This was a cross-sectional descriptive study performed at two urban hospital MRI centres. The study population was 147 children aged 1 day to 17 years with confirmed epilepsy. Brain MRI was performed for each child and a questionnaire was used to collect clinical data. Results The prevalence of structural abnormalities among children with epilepsy was 74.15% (109 out of 147). Of these, 68.81% were male, and the rest were female. Among these, the majority, 40.14% (59 of 144) were aged 1 month to 4 years. Acquired structural brain abnormalities were the commonest at 69.22% with hippocampal sclerosis (HS) leading while disorders of cortical development were the most common congenital causes. An abnormal electroencephalogram (EEG) was significant for brain MRI abnormalities among children with epilepsy with 95% of participants with an abnormal EEG study having epileptogenic structural abnormalities detected in their brain MRI studies. Conclusion and recommendation Two-thirds of children with epilepsy had structural brain abnormalities. Abnormal activity in the EEG study was found to positively correlate with abnormal brain MRI findings. As such, EEG study should be considered where possible before MRI studies as a determinant for children with epilepsy who will be having imaging studies done in the Ugandan setting.

Magnetic Resonance Imaging Findings and Their Association with Electroencephalographic Data in Children with Epilepsy at Tertiary Care Hospital in Mogadishu Somalia

“…were hippocampal sclerosis (HS), Hypoxic Ischaemic Encephalopathy (HIE) and Periventricular Leukomalacia (PV), 8 which was similar to our results. Two patients (2%) showed radiological findings of CNS infections, which were comparable to other studies.…”

“…7 These disruptions can cause numerous MCDs, including lissencephaly, hemimegalencephaly, polymicrogyria, heterotropia, and schizencephaly. 8 The aim of our study is to describe the frequency of EEG and MRI abnormalities among pediatric epilepsy patients and also to determine relationships between MRI and EEG abnormalities to find better diagnostic and treatment modalities for these children in Somalia context.…”

“…Two patients (2%) showed radiological findings of CNS infections, which were comparable to other studies. 8 Radiological evidence of malformations of cortical development (MC) was observed in 2 cases (2%). Varying rates of 3.8 to 8.84% have been reported in previous studies.…”

“…Varying rates of 3.8 to 8.84% have been reported in previous studies. 4,8 MCDs are epileptogenic and known to cause other complications, like global developmental delay. 15 One participant had brain neoplasms (1% of all abnormalities).…”