A clinical study to evaluate the association between clinical features, electroencephalographic changes, and neuroimaging in paediatric seizure disorders

Sanket Thakur; Dipankar Mondal; Pralhad Pode; Saurav Dey; Priyanka Mandal

doi:10.18203/2349-3291.ijcp20251854

Authors

Sanket Thakur Kings College and Hospital, London, UK
Dipankar Mondal Royal Blackbum Hospital, UK
Pralhad Pode Noble Hospital, Hadapsar, Pune, Maharashtra, India
Saurav Dey Bedford Teaching Hospital, UK
Priyanka Mandal GG Hospital, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20251854

Keywords:

GG Hospital, Chennai, Tamil Nadu, India

Abstract

Background: Seizure disorders in children are a significant cause of morbidity and present a diagnostic challenge due to varied clinical presentations and underlying aetiologies. Electroencephalography (EEG) and magnetic resonance imaging (MRI) are essential tools in evaluating these patients. This study aimed to analyse the association between clinical features, EEG findings, and MRI changes in paediatric patients presenting with seizures and to evaluate the diagnostic correlation among these modalities.

Methods: A prospective observational study was conducted on 60 paediatric patients presenting with seizures over an 18-month period at a tertiary care centre in Pune, Maharashtra. Detailed history, clinical examination, EEG, and MRI brain findings were collected and analysed for statistical significance.

Results: Generalized seizures were more common than focal seizures, with generalized tonic-clonic seizures (GTC) being the predominant type (73%). EEG abnormalities were found in 52% of cases, with generalized spike-wave discharges and focal spikes with generalization being most frequent. Temporal lobe involvement was the most common localization on EEG. MRI abnormalities were seen in 43% of cases, with periventricular white matter lesions being the most common (20%). Statistically significant associations were found between type of seizure and EEG abnormality (p<0.01), and between EEG and precipitating factors (p=0.02). However, no significant correlation was found between EEG and MRI localization (p>0.05).

Conclusions: EEG and MRI are crucial complementary tools in the evaluation of paediatric seizures. While EEG abnormalities were more common in complex partial seizures, MRI was more likely to show abnormalities in cases with focal neurological signs. Routine use of both EEG and MRI is recommended in the initial evaluation of paediatric seizure disorders to improve diagnostic accuracy.

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