Magnetic Resonance Imaging and Electroencephalography findings in Developmentally Normal Children aged between 2 Months to 12 Years presenting with New Onset Seizures

INTRODUCTION: “An epileptic seizure is a transient occurrence of signs and symptoms resulting from abnormal excessive synchronous neuronal activity of the brain.” The word seizure is of Greek origin, the root word being “seiein” which means “to shake”. “Epilepsy is a disease of the brain characterized by an enduring predisposition to generate epileptic seizures.” It is also characterized by the neurobiological, cognitive, psychological, and social consequences of the condition. Epilepsy is a disorder of the brain defined by any of the three: 1. Two or more unprovoked seizures which occurs >24 h apart. 2. One unprovoked seizure and a chance of occurrence of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years. 3. Diagnosis of an electro clinical syndrome. Epilepsy is said to be resolved in those children who had an age specific epilepsy syndrome but now have crossed that age group or children who have been seizure-free for the past ten years, with no antiepileptics for the past five years. OBJECTIVE: The aim of the study was to identify the pattern of abnormalities in MRI and EEG in developmentally normal children presenting with new onset seizures. METHODS: The study was a prospective observational study conducted in our hospital, Institute of Child Health and Hospital for Children for a period of six months. The study included children who presented with new onset seizures in the age group 2 months to 12 years. Children with simple febrile seizures, acute CNS infection, trauma, toxin, metabolic seizures, chronic neurological illness were excluded. All the children underwent complete neurological examination, MRI brain and EEG. RESULTS: The study included 100 children from 2months to 12 years. The results were statistically analyzed. The most common age group of children presenting new onset seizures was 6 to 12 years, mean age being 5.4 years. The commonest seizure type was generalized tonic clonic seizures. Eleven percent of the children presented with status epilepticus as the first episode of new onset seizures. MRI abnormalities were seen in 29% of the children most common finding being Ring enhancing lesion(65.5%). EEG abnormalities were seen in 38% of the children, commonest abnormality being generalized spikes(63.2%). CONCLUSIONS: Ring enhancing lesion is the most common abnormality in neuroimaging detected in children presenting with new onset seizures. Generalized epileptiform activity is the commonest EEG abnormality noted in children with new onset seizures