Magnetic Resonance Imaging in Epileptic Children and its Association with Electroencephalography and Clinical Findings: A Cross-sectional Study

Introduction: Epilepsy is a global health problem decreasing the quality of life of many children. Neuroimaging particularly, Magnetic Resonance Imaging, (MRI) plays a crucial role in precisely identifying epileptogenic foci that are potentially amenable to surgical resection for a possible cure. Aim: To assess the diagnostic accuracy of MRI in the detection and characterisation of causes of paediatric epilepsy and evaluating association of the diagnostic yield of MRI with the electroencephalogram and the clinical features. Materials and Methods: This was across-sectional observational study comprising of 100 children with epilepsy in the age group of 1 month-18 years from December 2017 to December 2019. The mean age of presentation was 8.79 +/- 6.12 years. The patient's clinical data and surface electroencephalogram data were recorded. Subsequently performed BRAIN-MRI was associated with the EEG and neurological findings. Data obtained were recorded and statistical analysis was done using Statistical Package for Social Sciences (SPSS) 23 program. Results: Among 100 children 53% were boys and 47% were girls. The mean age of presentation was 8.79 +/- 6.12 years. In the present study, 57% of children had generalised tonic-clonic seizures, 21% had partial seizures, 16% had absence seizures and 6% had myoclonic seizures. On MRI investigation, 61% were found to be normal and 39% were MRI positive. Among the positive cases, the maximum numbers of cases were of cortical gliosis (10%). On statistical evaluation, a significant association was established between the MRI and EEG findings (p=0.03) and MRI and neurological findings (p=0.001). Conclusion: MRI plays a significant role in the evaluation of paediatric epilepsy and it is the imaging modality of choice to establish the correct diagnosis owing to its high spatial resolution and excellent soft-tissue contrast, making MRI the most versatile and useful diagnostic imaging tool for epilepsy patients.