Role of Electroencephalogram and Neuroimaging in First Afebrile Seizure in Children: A Retrospective Study

Abstract

Background:To evaluate the role of EEG and Magnetic resonance imaging (MRI) in first episode of unprovoked afebrile seizure in a child. Subjects and Methods: Data was collected retrospectively from case records of patients admitted with seizures during the period between January 2016 to December 2018. All children with first episode of unprovoked afebrile seizure (1-15 years of age) were included in the study. Results: Case records of 108 patients with first episode of unprovoked afebrile seizures were reviewed . Out of these , 65 patients were investigated with MRI and EEG.54 children (83.1%)had generalized tonic clonic seizures(GTCS), 11 had partial seizures (16.9 %) . EEG abnormalities were seen in 21 children, predominantly in GTCS type. The most common EEG abnormality observed was sharp and spike wave discharges .7 children (10.7 %) had abnormal (MRI). The accuracy of MRI detecting the abnormality when EEG was abnormal was 33.3 % (p < 0.05). Conclusion: This study illustrates that routine neuroimaging for all children with first episode of unprovoked afebrile seizures is gratuitous. Neuroimaging can be reserved for those patients with recurrence of seizures or those children with clinical findings suggestive of intracranial pathologies.