Diagnostic utility of electroencephalography and magnetic resonance imaging in children with a first unprovoked seizure: a prospective observational study

Vinay Kumar N.; Harini Venugopal; Chandan H. C.; Prashanth S.

doi:10.18203/2349-3291.ijcp20263275

Authors

Vinay Kumar N. Department of Pediatrics, Mysore Medical College, Mysore, Karnataka, India
Harini Venugopal Department of Pediatrics, Mysore Medical College, Mysore, Karnataka, India
Chandan H. C. Department of Pediatrics, Mysore Medical College, Mysore, Karnataka, India
Prashanth S. Department of Pediatrics, Mysore Medical College, Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20263275

Keywords:

First unprovoked seizure, EEG, MRI, Epilepsy, Neuroimaging

Abstract

Background: Electroencephalography (EEG) is recommended as part of the neurodiagnostic evaluation of children presenting with a first unprovoked seizure. However, the role of neuroimaging, particularly magnetic resonance imaging (MRI), remains less clearly defined. This study aimed to evaluate the diagnostic utility of EEG and MRI in children presenting with a first episode of unprovoked seizure.

Methods: This prospective observational study was conducted at Mysore Medical College, Mysuru. Children presenting with a first unprovoked seizure were enrolled after obtaining parental consent. Detailed clinical and developmental histories were taken and general and neurological examinations were done. A complete blood count, blood glucose, serum sodium, potassium, and calcium were done to rule out metabolic causes. Seizures were classified according to the International League Against Epilepsy classification. EEG was done within 48 hours of the seizure using the 18‐channel EEG machine and interpreted by a pediatric neurologist. Cranial MRI was performed on a 1.5-Tesla scanner. EEG and MRI findings were classified as normal or abnormal.

Results: EEG abnormalities were present in 62.5% of children and MRI abnormalities in 25%. MRI abnormalities were identified in some children with normal EEG findings, including developmental abnormalities and ring-enhancing lesions.

Conclusions: EEG demonstrated a substantial diagnostic yield and should be considered an important investigation in children presenting with a first unprovoked seizure. MRI abnormalities were less common but can provide further diagnostic information for some children with normal EEG findings and may aid in detection of structural and developmental problems.

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