Magnetic resonance imaging (MRI) findings in pediatric epilepsy

MRI findings in childhood’s epilepsy

Abstract

Background: Epilepsy is a neurological condition characterized by irregular, rapid, and synchronized neuronal discharges from the cerebral cortex. Advances in neuroimaging have significantly enhanced the diagnosis, treatment, and management of pediatric epilepsy. Structural magnetic resonance imaging (MRI), when evaluated by skilled neuroradiologists, facilitates improved identification of the seizure onset zone using epilepsy-specific MRI protocols. Objective: This review aims to analyze cerebral MRI findings in pediatric epilepsy across age groups and sexes. Materials and Methods: A comprehensive literature review was conducted using major scientific databases, including PubMed, ScienceDirect, and SciELO. Articles were screened based on inclusion criteria, starting with titles, followed by abstract and full-text evaluations. The following keywords were used in the literature search: "Magnetic Resonance Imaging" or "MRI" AND "Childhood" or "Pediatric" AND "Epilepsy." Results: Analysis of 16 studies revealed 1,504 MRI anomalies. Cortical malformations were the most frequent anomaly, identified in 230 cases (15%). The second most frequent finding, hippocampal/mesial temporal sclerosis, was observed in 160 subjects (10%). Other anomalies included infections in 76 subjects (5%), brain tumors in 37 subjects (2%), periventricular leukomalacia in 37 subjects (2%), encephalomalacia in 65 subjects (4%), vascular disorders in 41 subjects (2.7%), cysts in 75 subjects (5%), hydrocephalus in 33 subjects (2.1%), and demyelination disorders in 33 subjects (2.1%).  Conclusion:  MRI scanning is particularly beneficial for children with newly diagnosed epilepsy, especially those with focal seizures, focal EEG abnormalities, or abnormal neurological examinations. It is also valuable for children who present with refractory seizures that other imaging modalities are unable to detect.