Rana Al-Shami1, Abdulhafeez M Khair1, Mahmoud Elseid2, Khalid Ibrahim2, Amna Al-Ahmad1, Ahmed Elsetouhy3, Hussein Kamel3, Khalid Al Yafei4, Khalid Mohamed5. 1. Pediatric Neurology Division, Hamad Medical Corporation, Doha, Qatar. 2. Pediatric Neurology Division, Hamad Medical Corporation, Doha, Qatar; Weil Cornell Medical College, Qatar. 3. Neuro-radiology Division, Hamad Medical Corporation, Doha, Qatar; Weil Cornell Medical College, Qatar. 4. Emergency Division, Hamad Medical Corporation, Doha, Qatar; Weil Cornell Medical College, Qatar. 5. Pediatric Neurology Division, Hamad Medical Corporation, Doha, Qatar; Weil Cornell Medical College, Qatar. Electronic address: kmohamed9@hamad.qa.
Abstract
PURPOSE: To evaluate the role of neuro-imaging in children presenting with the first afebrile seizure and determine factors that influence the outcome of imaging in a large paediatric emergency centre. METHOD: This is a retrospective review of the medical records of all patients presenting with the first non-febrile seizure to a large paediatric emergency centre in the state of Qatar. Seizure classification followed the current ILAE classification system. Imaging was undertaken in our tertiary hospital and all images were reviewed by experienced neuro-radiologists. Student t test was used for statistical analysis. RESULTS: Ninety-six children underwent neuro-imaging following the first afebrile seizure. Of them, thirty-two patients (33%) were reported to have abnormalities. Children below the age of two demonstrated a significantly higher percentage of abnormal imaging (59%); (p=0.002). Children presenting with prolonged seizures showed a high percentage of imaging abnormalities (58%); (p=0.003). Children with focal seizures demonstrated a higher percentage of imaging abnormality compared to those presenting with generalized seizures (35% vs 31%). This difference did not reach statistical significance. CONCLUSION: Children below the age of two demonstrated significantly higher percentages of abnormal imaging (59%), as did children presenting with status epilepticus (58%). Neuro-imaging should be considered in infants and those with focal or prolonged seizures. Neuro-imaging informed decision making in 6-8% of children.
PURPOSE: To evaluate the role of neuro-imaging in children presenting with the first afebrile seizure and determine factors that influence the outcome of imaging in a large paediatric emergency centre. METHOD: This is a retrospective review of the medical records of all patients presenting with the first non-febrile seizure to a large paediatric emergency centre in the state of Qatar. Seizure classification followed the current ILAE classification system. Imaging was undertaken in our tertiary hospital and all images were reviewed by experienced neuro-radiologists. Student t test was used for statistical analysis. RESULTS: Ninety-six children underwent neuro-imaging following the first afebrile seizure. Of them, thirty-two patients (33%) were reported to have abnormalities. Children below the age of two demonstrated a significantly higher percentage of abnormal imaging (59%); (p=0.002). Children presenting with prolonged seizures showed a high percentage of imaging abnormalities (58%); (p=0.003). Children with focal seizures demonstrated a higher percentage of imaging abnormality compared to those presenting with generalized seizures (35% vs 31%). This difference did not reach statistical significance. CONCLUSION:Children below the age of two demonstrated significantly higher percentages of abnormal imaging (59%), as did children presenting with status epilepticus (58%). Neuro-imaging should be considered in infants and those with focal or prolonged seizures. Neuro-imaging informed decision making in 6-8% of children.
Authors: Rayan A Alzahrani; Ameera F Alghamdi; Mohammed A Alzahrani; Majed A Alghamdi; Malak F Alghamdi; Amjad A Alzahrani; Abdullah M Alghamdi; Manal K Alzahrani; Talal S Alghamdi; Rahaf S Alghamdi; Fahad A Alqarni; Ahmed H Al-Zahrani; Faisal M Al-Hawaj Journal: Cureus Date: 2021-11-16