DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20180515

Evaluation of neuroimaging findings in new onset afebrile seizures in children

Maheshkumar Muthuraja, Manikandan Paramasivam

Abstract


Background: New onset afebrile seizures are very common in children. They are diagnosed by neuroimaging techniques. The aim of the present study was to examine the presenting characteristics and to assess and compare the prevalence of neuroimaging and neurological abnormalities in new onset afebrile seizures in children.

Methods: This prospective study was conducted in a tertiary care hospital at Chennai during the period from July 2014 to August 2016. Out of 65 patients included in the study, 58 had an MRI, 5 had a CT scan and 2 patients had a neurosonogram. All the findings were documented in the proforma and evaluated for incidence of neuroimaging abnormality in children.

Results: The most common age group to be affected was the adolescent age group followed by the infantile group. The most common presentation noticed was generalized seizures 72% (47/65). Among the primary generalized seizures, GTCS 57% (27/47) was the most common. Of the 65 patients in our study, 22 had Neuroimaging abnormality and 16 had neurological abnormality. The most common abnormalities seen in various neuroimaging studies were ring enhancing lesions 10 (45%). Ring enhancing lesions were more common in the adolescent age group, while structural disorder was more common in the infantile age group.

Conclusions: Neuroimaging techniques helped in finding the brain developmental abnormalities among children with afebrile seizures.


Keywords


Afebrile seizures, Neuroimaging abnormalities, Neurological abnormalities

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References


Johnston MV. Seizure in childhood. In: Klieg man RM, Behrman RE, eds. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders; 2010:2457-2470.

Mikati MA. Seizures in Childhood. In: Klieg man RM, Stanton BF, St. Geme, Schor NF, Behrman RE, eds. Nelson textbook of pediatrics. 19th ed. Philadelphia: Saunders; 2011:2013-2039.

Landfish N, Gieon-Korthals M, Weibley RE, Panzarino V. New onset childhood seizures. Emergency department experience. J Fla Med Assoc. 1992;79:679-700.

Warden CR, Browstein DR, Del Baccaro MA. Predictors of abnormal findings of computed tomography of the head in pediatric patients presenting with seizures. Ann Emerg Med. 1997;29:518-23.

Gaillard WD, Chiron C, Cross JH, Harvey AS, Kuzniecky R, Hertz-pannier L, et al. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia. 2009;50(9):2147-53.

Poudel P, Parakh P, Mehta K. Clinical profile, aetiology and outcome of afebrile seizures in children. J Nepal Med Assoc. 2013;52(189):260-6.

Sidenvall R, Heijbel J, Blomquist HK, Nyström L, Forsgren L. An incident case-control study of first unprovoked afebrile seizures in children: a population-based study of pre- and perinatal risk factors. Epilepsia. 2001;42(10):1261-5.

Hirtz D, Ashwal S, Berg A. Practice parameter: Evaluating a first nonfebrile seizure in children: Report of the Quality Standards Subcommittee of the American Academy of Neurology, the Child Neurology Society and the American Epilepsy Society. Neurol. 2000;55:616-23.

Michoulas A, Farrell K, Connolly M. Approach to a child with a first afebrile seizure. BCMJ. 2011;53:274-7.

Rasool A, Choh SA, Wani NA, Ahmad S M, Iqbal Q. Role of electroencephalogram and neuroimaging in first onset afebrile and complex febrile seizures in children from Kashmir. J Pediatr Neurosci. 2011;7:9-15.

Tavassoli A, Noormohamadi S. Factors related to abnormal neuroimaging in children with first unprovoked seizure. Iran J Child Neurol. 2011;5(1):15-20.

Camfield CS, Camfield PR, Gordon K, Wirrell E, Dooley JM. Incidence of epilepsy in childhood and adolescence: a population-based study in Nova Scotia from 1977 to 1985. Epilepsia. 1996;37:19-23.

Hauser WA, Kurland LT. The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia. 1975;16:1.

Khodapanhandeh F, Harizadeh H. Neuroimaging in children with first afebrile seizure. Arch Iranian Med. 2006;9:156-8.

Kalnin AJ, Fastenau PS, deGrauw TJ, Musick BS, Perkins SM, Johnson CS, et al. Magnetic resonance imaging findings in children with a first recognized seizure. Pediatr Neurol. 2008;39:404-14.

Mathur S, Southern K. Significant Findings on Cranial CT scan After a First Unprovoked Seizure in Children from North India. J Trop Pediatr 2007;53(6):428-30.

Mohammadi MM, Tonekaboni SH, Khatami AR, Azargashb E, Tavasoli A, Javadzadeh M, et al. Neuroimaging Findings in first unprovoked seizures: a multicentric study in Tehran. Iran J Child Neurol. 2013;7(4):24-31.

Alawneh HI, Bataineh HA. Urgent neuroimaging in children with first nonfebrile seizures. Middle Eat J Family Med. 2008;6(1)24-7.

Singhi S, Singhi P. Clinical profile and etiology of partial seizures in North Infants and children. J Epilepsy. 1997;10:32-6.

Saini N, Baghel A. Neuroimaging abnormalities in children with first afebrile seizure. IOSR J Dental Med Sci. 2013;5:21-4.

Sachdev HPS, Shiv VK, Bhargava SK, Dubey AP, Choudhury P, Puri RK. Reversible computerized tomographic lesions following childhood seizures. J Trop Pediatr. 1991;37:121-6.

Aprahamian N, Harper MB, Prabhu SP, Monuteaux MC, Sadiq Z, Torres A, et al. Pediatric first time nonfebrile seizure with focal manifestations: is emergent imaging indicated? Seizure. 2014;23(9):740-5.