Low-Field Magnetic Resonance Imaging Findings in Children with Seizures in Ibadan, Nigeria
DOI:
https://doi.org/10.30442/ahr.0604-04-102Keywords:
Adolescents, Brain tumours, Children, Magnetic Resonance Imaging, SeizuresAbstract
Background: Seizure is the most common neurological disorder in children and an important cause of paediatric hospital admission with the highest prevalence in the under-five age group. Magnetic Resonance Imaging (MRI) is the neuro-imaging technique of choice in the initial evaluation of children with epilepsy. High-field MRI is the ideal imaging modality for evaluating seizures but this is not readily available in developing countries.
Objective: To analyse the spectrum of MRI findings in children presenting with seizures using a low-field (0.36T) MRI.
Methods: Children aged ≤18years with seizures, with cranial MRI at the University College Hospital (UCH), Nigeria between January 2013 and June 2015 were retrospectively reviewed.
Results: There were a total of 134 patients with 53% as adolescents and most of them (85; 63.4%) had abnormal cranial MRI findings. More male children had abnormal findings (52; 61.2%) and most abnormal findings (42; 49.4%) were reported among adolescents. The most frequent abnormality was hydrocephalus (23.5%) from various causes followed by cerebral tumours (14.1%) and ischaemic cerebral infarcts (11.8%). In the adolescents, intracranial tumours (21.4%) were the most frequent abnormal findings, while hydrocephalus was commoner in children aged less than 10 years, accounting for 33.3% and 36.0% among the 1-5 years and 6-11 years age groups respectively.
Conclusion: Low-field MRI, which is more readily available, can provide substantial preliminary findings to aid the management of children with epilepsies. Improved access to high-field MRI through cost reduction and early MR imaging evaluation in the course of illness are desirable.
References
Ba-diop A, Marin B, Druet-Cabanac M, Ngoungou EB, Newton CR, Preux P-M. Epidemiology, causes, and treatment of epilepsy in sub-Saharan Africa. Lancet Neurol 2017; 13: 1029–1044. doi:10.1016/S1474-4422(14)70114-0.
Boling W, Means M, Fletcher A. Quality of Life and stigma in epilepsy, perspectives from selected regions of Asia and Sub-Saharan Africa. Brain Sci 2018; 8: 54-92. doi:10.3390/brainsci8040059.
Mwipopo EE, Akhatar S, Fan P, Zhao D. Profile and clinical characterization of seizures in hospitalized children. Pan Afr Med J 2016; 24: 313-341. https://doi.org/10.1186/1471-2431-13-43.
Chaudhary N, Gupta MM, Shrestha S, Pathak S, Kurmi OP, Bhatia BD, et al. Clinicodemographic profile of children with seizures in a Tertiary Care Hospital: A Cross-sectional observational study. Neurol Res Int 2017; 2017: 1–6. doi:10.1155/2017/1524548.
Aaberg KM, Gunnes N, Bakken IJ, Søraas CL, Berntsen A, Magnus P, et al. Incidence and prevalence of childhood epilepsy: A nationwide cohort study. Artic Pediatr 2017; 139: e20163908. https://doi.org/10.1542/peds.2016-3908.
Mungdala-odeara V, White S, Otieno GO, Njuguna T, Mturi N ET. Prevalence, incidence and risk factors of epilepsy in older children in rural Kenya. Sci Direct 2008; 17: 396–404. http://doi.org/10.1016/j.seizure.2007.11.028.
Prabhu S, Mahomed N. Imaging of intractable paediatric epilepsy. S Afr J Rad. 2015; 19: 1-10. https://doi.org/10.4102/sajr.v19i2.936.
Mustafa C, Ekrem KNC. Clinical importance of neuroimaging in epilepsy. J Neurosci Rural Pract 2013; 4: 11–12. doi:10.4102/sajr.v19i2.936.
Ogbole GI, Adeyomoye AO, Badu-Peprah A, Mensah Y, Nzeh DA. Survey of magnetic resonance imaging availability in West Africa. Pan Afr Med J 2018; 30: 240. doi:10.11604/pamj.2018.30.240.14000.
Ndubuisi CA, Mezue WC, Ohaegbulam SC, Chikani MC, Ekuma M, Onyia E. Neuroimaging findings in pediatric patients with seizure from an institution in Enugu. Niger J Clin Pract 2016; 19: 121–127. doi:10.4103/1119-3077.173712.
Sahdev R, Rao A, Sinha S. Neuroimaging in pediatric seizures. l Int J Res Med Sci 2017; 5: 295–299. https://dx.doi.org/10.18203/2320-6012.ijrms20164566.
Amirsalari S, Saburi A, Hadi R, Mirmohammad SM. Magnetic Resonance Imaging (MRI) findings in epileptic children and its relation with clinical and demographic findings. Acta Med Iran 2012; 50: 37-42. https://doi.org/10.1038/pr.2011.371.
Anand A, Disawal A, Bathwal P, Bakde A. Magnetic Resonance Imaging Brain in the evaluation of pediatric epilepsy. Int J Sci Stud 2017; 5: 8-14. doi:10.17354/ijss/2017/547.
Kim JD, Park DW, Eun TK, Chung DH, Hwang TK. Brain MRI Findings of Complex Partial Seizure in Children. J Korean Radiol Soc 1992; 28: 631-638.
Kalnin AJ, Fastenau PS, deGrauw TJ, Musick BS, Perkins SM, Johnson CS, et al. MR Imaging findings in children with first recognized seizure. Pediatr Neurol 2008; 39: 404–414. doi:10.1016/j.pediatrneurol.2008.08.008.
Chaurasia R, Singh S, Mahur S, Sachan P. Imaging in Pediatric Epilepsy: Spectrum of Abnormalities detected on MRI. J Evolution Med Dent Sci 2013; 2: 3377-3388. doi:
14260/jemds/707.
Fitsiori A, Garibotto V. Hiremath SB, Vargas MI. Morphological and advanced imaging of epilepsy: Beyond the Basics. Children 2019; 6: 43-66. doi:10.3390/children6030043.
Skjei KL., Dlugos DJ. The evaluation of treatment-resistant epilepsy. Semin Pediatr Neurol 2011; 18: 150–170. doi:10.1016/j.spen.2011.06.002.
Wang ZI, Alexopoulos AV, Jones SE, JaisaniZ, Najm IM, Prayson RA. The pathology of magnetic resonance imaging-negative epilepsy. Mod Pathol 2013; 26: 1051–1058. doi:10.1038/modpathol.2013.52.
Bien CG, Szinay M, Wagner J, Clusmann H, Becker AJ, Urbach H. Characteristics and surgical outcomes of patients with refractory magnetic resonance imaging-negative epilepsies. Arch Neurol 2009; 66: 1491–1499. doi:10.1001/archneurol.2009.283.
Phal PM, Usmanov A, Nesbit GM, Anderson JC, Spencer D, Wang P, et al. Qualitative comparison of 3-T and 1.5-TMRI in the evaluation of epilepsy. Am J Roentgenol 2008; 191: 890–895. doi:10.2214/AJR.07.3933.
Mellerio C, Labeyrie MA, Chassoux F, Roca P, Alami O, Plat M, et al. 3T MRI improves the detection of transmantle sign in type 2 focal cortical dysplasia. Epilepsia 2014; 55: 117–122. doi: 10.1111/epi.12464.
Zijlmans M, De Kort GA, Witkamp TD, Huiskamp GM, Seppenwoolde JH, van Huffelen AC, et al. 3T versus 1.5T phased-array MRI in the presurgical work-up of patients with partial epilepsy of uncertain focus. J Magn Reson Imaging 2009; 30: 256–262. doi:10.1002/jmri.21811.
Ahluwalia VV, Sharma N, Chauhan A, Narayan S, Saharan PS, Agarwal D. MRI imaging in afebrile pediatric epilepsy: experience sharing. Int J Contemp Pediatr 2017; 4: 300-305. https://dx.doi.org/10.18203/2349-3291.ijcp20164626.
Lagunju IO, Oyinlade AO, Atalabi OM, Ogbole G, Tedimola O, Famosaya ID, et al. Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting. Pan Afr Med J 2015; 22: 328. doi:10.11604/pamj.2015.22.328.7065.
Chen G., Lei D, Ren J, Zuo P, Suo X, Wang D, et al. Patterns of postictal cerebral perfusion in idiopathic generalized epilepsy: a multi-delay multi-parametric arterial spin labelling perfusion MRI study. Sci Rep 2016; 6: 28867. https://doi.org/10.1038/srep28867.
Shang K, Wang J, Fan X, Cui B, Ma J, Yang H, et al. Clinical value of Hybrid TOF-PET/MR Imaging-Based Multiparametric Imaging in localizing seizure focus in patients with MRI-Negative Temporal Lobe Epilepsy. Am J Neuroradiol 2018; 39; 1791-1798. doi:10.3174/ajnr.A5814.
Berg AT, Shinnar S, Levy SR, Testa FM. Newly diagnosed epilepsy in children: presentation at
diagnosis. Epilepsia 1999; 40: 445–452. https://doi.org/10.1111/j.1528-1157.1999.tb00739.
Wellmer J, Quesada, CM., Rothe, L, Elger, CE., Bien CG, Urbach H. Proposal for a magnetic resonance imaging protocol for the detection of epileptogenic lesions at early outpatient stages. Epilepsia 2013; 54: 1977–1987. doi: 10.1111/epi.12375.
Osuntokun BO, Adeuja AOG, Nottidge VA, Bademosi O, Olumide A, Ige O, et al. Prevalence of the epilepsies in Nigerian Africans: a community-based study. Epilepsia 1987; 28: 272-279. doi:10.1111/j.1528-1157.1987.tb04218.x
Owolabi LF, Ogunniyi A. Etiology and electroclinical pattern of late-onset epilepsy in Ibadan, Southwestern Nigeria. Afr J Neurol Sci 2015; 34: 25-33.
Downloads
Published
Issue
Section
License
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.