R Hourani1, W Nasreddine2, M Dirani2, G Hmaimess3, S Sabbagh4, O El Tourjuman5, J Wazne5, H Toufaili6, N AlArab1, M El Dassouki5, A Beydoun7. 1. From the Departments of Radiology (R.H., N.A.). 2. Neurology (W.N., M.D., A.B.), American University of Beirut Medical Center, Beirut, Lebanon. 3. Department of Pediatrics (G.H.), St George Hospital Medical University Center, University of Balamand, Beirut, Lebanon. 4. Department of Pediatrics (S.S.), Hotel Dieu de France Hospital, Beirut, Lebanon. 5. Department of Neurology (O.E.T., J.W., M.E.D.), Rafic Hariri University Hospital, Beirut, Lebanon. 6. Labib Medical Center (H.T.), Beirut, Lebanon. 7. Neurology (W.N., M.D., A.B.), American University of Beirut Medical Center, Beirut, Lebanon ab29@aub.edu.lb.
Abstract
BACKGROUND AND PURPOSE: There is a paucity of data regarding the incidence of structural brain lesions in children with new-onset unprovoked seizures. Our aim was to determine the frequencies and types of epileptogenic lesions detected on a dedicated epilepsy protocol MR imaging according to age group, the presence of developmental delay, and the number and types of seizures. MATERIALS AND METHODS: Consecutive children between 6 months and 18 years of age with new-onset unprovoked seizures were included. The frequencies and types of epileptogenic lesions were determined and then stratified according to sex, age groups, the presence of developmental delay, and the number and types of seizures at presentation. Multivariate analysis was used to identify variables significantly associated with the presence of epileptogenic lesions. RESULTS: One thousand children were included. An epileptogenic lesion was identified in 26%, with malformations of cortical development being the most common lesion (32%), followed by hypoxic-ischemic injury (20%) and vascular etiologies (16%). Univariate analysis showed a significant increase in the frequency of epileptogenic lesions with decreasing age, the presence of developmental delay, and the number and types of seizures at presentation. The presence of developmental delay and seizure type at presentation remained significant in a multivariate analysis. CONCLUSIONS: We documented a relatively high rate of epileptogenic lesions in children with new-onset seizures, with the presence of developmental delay and specific seizure types being associated with a higher likelihood of detecting an epileptogenic lesion on neuroimaging. This study fulfills the requirements of the study design recommended by the Practice Committee of the American Academy of Neurology, and we hope that our results will assist the relevant societies and committees in formulating neuroimaging guidelines for children with new-onset seizures.
BACKGROUND AND PURPOSE: There is a paucity of data regarding the incidence of structural brain lesions in children with new-onset unprovoked seizures. Our aim was to determine the frequencies and types of epileptogenic lesions detected on a dedicated epilepsy protocol MR imaging according to age group, the presence of developmental delay, and the number and types of seizures. MATERIALS AND METHODS: Consecutive children between 6 months and 18 years of age with new-onset unprovoked seizures were included. The frequencies and types of epileptogenic lesions were determined and then stratified according to sex, age groups, the presence of developmental delay, and the number and types of seizures at presentation. Multivariate analysis was used to identify variables significantly associated with the presence of epileptogenic lesions. RESULTS: One thousand children were included. An epileptogenic lesion was identified in 26%, with malformations of cortical development being the most common lesion (32%), followed by hypoxic-ischemic injury (20%) and vascular etiologies (16%). Univariate analysis showed a significant increase in the frequency of epileptogenic lesions with decreasing age, the presence of developmental delay, and the number and types of seizures at presentation. The presence of developmental delay and seizure type at presentation remained significant in a multivariate analysis. CONCLUSIONS: We documented a relatively high rate of epileptogenic lesions in children with new-onset seizures, with the presence of developmental delay and specific seizure types being associated with a higher likelihood of detecting an epileptogenic lesion on neuroimaging. This study fulfills the requirements of the study design recommended by the Practice Committee of the American Academy of Neurology, and we hope that our results will assist the relevant societies and committees in formulating neuroimaging guidelines for children with new-onset seizures.
Authors: Ingrid E Scheffer; Samuel Berkovic; Giuseppe Capovilla; Mary B Connolly; Jacqueline French; Laura Guilhoto; Edouard Hirsch; Satish Jain; Gary W Mathern; Solomon L Moshé; Douglas R Nordli; Emilio Perucca; Torbjörn Tomson; Samuel Wiebe; Yue-Hua Zhang; Sameer M Zuberi Journal: Epilepsia Date: 2017-03-08 Impact factor: 5.864
Authors: S Knake; C Triantafyllou; L L Wald; G Wiggins; G P Kirk; P G Larsson; S M Stufflebeam; M T Foley; H Shiraishi; A M Dale; E Halgren; P E Grant Journal: Neurology Date: 2005-10-11 Impact factor: 9.910
Authors: D Battaglia; T Randò; F Deodato; G Bruccini; G Baglio; M F Frisone; T Pantò; G Tortorella; F Guzzetta Journal: Eur J Paediatr Neurol Date: 1999 Impact factor: 3.140
Authors: Jason Coryell; William D Gaillard; Renée A Shellhaas; Zachary M Grinspan; Elaine C Wirrell; Kelly G Knupp; Courtney J Wusthoff; Cynthia Keator; Joseph E Sullivan; Tobias Loddenkemper; Anup Patel; Catherine J Chu; Shavonne Massey; Edward J Novotny; Russel P Saneto; Anne T Berg Journal: Pediatrics Date: 2018-08-08 Impact factor: 7.124
Authors: Andrew J Kalnin; Philip S Fastenau; Ton J deGrauw; Beverly S Musick; Susan M Perkins; Cynthia S Johnson; Vincent P Mathews; John C Egelhoff; David W Dunn; Joan K Austin Journal: Pediatr Neurol Date: 2008-12 Impact factor: 3.372