The prevalence and spectrum of brain mri findings among children with seizure disorders as seen at two imaging centres in Kampala.

Abstract

Background: Epilepsyis one of the most common neurological conditions in children worldwide. It is a common occurrence in childhood as it is associated with developmental delay and causes a lot of distress to care givers of the afflicted. It is prudent to investigate the cause of seizure disorders as it will guide management and predict prognosis. There are many recognised causes of seizure disorders and brain Magnetic Resonance Imaging (MRI) is the gold standard in assessment for the structural causes. We aimed to determine the prevalence and describe the structural abnormalities identified in the brain MRI studies done in children with seizure disorders in Uganda. Methods: This was a cross-sectional descriptive study performed at Nsambya and Nakasero Hospital MRI centres. The study population was 147 children aged 1 day to 17 years with confirmed epilepsy. Brain MRI was performed for each child and a questionnaire used to collect clinical and radiological data. Results: The prevalence of structural abnormalities among children with seizure disorders was 74.15% (109 out of 147). Of these, 68.81% were male and the rest female with a ratio of 2:1. Among these patients the majority, 40.14% (59 out of 144) were aged 1 month to 4 years. Acquired structural brain abnormalities were the commonest at 69.22% with Mesial Temporal Sclerosis (MTS) as the commonest acquired abnormality while disorders of cortical development were the most common congenital causes. An abnormal Electroencephalogram(EEG) was significant for brain MRI abnormalities among children with epilepsy. Conclusion and Recommendation: Two thirds of children with epilepsy had structural abnormalities identified on their brain MRI studies of a predominantly acquired etiology. Abnormal activity on the EEG study was found to have a positive correlation with abnormal brain MRI findings and as such should be considered where possible before MRI studies as a determinant for children with seizures who will be have imaging studies done in this setting.