THE FREQUENCY OF MRI ABNORMALITIES IN CHILDREN WITH EPILEPSY

Objectives: MRI is often routinely ordered in child with epilepsy. The frequency of clinical significant abnormalities on MRI in this population is unclear.

Methods: Case ascertainment was from MRI log. Patient aged 1 and 17 years of with epilepsy were included. Five year study period was used. Medical charts were reviewed for seizure type and EEG pattern. MRI scans were re-read and classified as to type of abnormality present.

Results: 529 patients were reviewed. Seizure types were partial seizures in 65%, generalized tonic clonic seizures 21%, and 14%mixed seizure types. EEG patterns were generalized spikes in 15%, focal spikes in 33%, focal and generalized spikes 8% and no epileptiform features 41%. 69% had normal MRI; whereas, 9% had cortical malformation, 1%mesial temporal sclerosis,7%focal atrophy, 2%mass lesion, 2% vascular lesion and 10% nonspecific changes. The cortical malformations were 70%focal dysplasia, 16%agenesis of corpus callosum, 10%cerebellar hypoplasia and 2% cleft schizocephaly.

Conclusion: The frequency of clinical significant MRI findings in children with epilepsy is relatively low.