Online ISSN: 2515-8260

Evaluation of seizure disorder on MRI brain with age wise correlation of various causes diagnosed on MRI.

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Dr. Apurva Shukla1 (Resident), Dr. Akshara Gupta2 (Professor & Head), Dr. Dinesh Udainiya3 (Professor & Head) & Dr. Sweta Swaika4 (Assistant Professor

Abstract

Background-The objective behind this study is to detect and study causes of seizure in patients with seizure disorder on MRI Brain and to age wise correlate most common causes found in different age groups, in a tertiary care hospital in Northern India. Material and Methods A total of 100 patients with clinical symptoms of seizures who were referred for MRI for diagnosis and evaluation, from the department of Neurology to the Department of Radio diagnosis, JAH Group of hospitals & G.R.M.C. Gwalior (M.P.) were included in the study. All MRI scans were performed on a 1.5 T Philips scanner with sequences of seizure protocol. Data was analyzed using SPSS version 16.0 and EPI INFO version 7.0. Results The mean age of presentation with seizure in our study was 20.5 years with male predominance seen. Age groups were divided into four categories ≤1year, 1-18 years, 18-40 years and >40 years for the purpose of our study with 17 patients found in ≤1year group, 37 patients in 1-18 year age group, 28 patients in 19-40 year and 18 patients in >40 year age group. Normal MRI was seen in 29 out of 100 patients (29%). Infarct with gliosis was the most common finding in seizure patients (26% ) in our study followed by HIE (hypoxic ischemic encephalopathy) (17% with most common age group being ≤1year) & infection (15%). Other causes found were mesial temporal sclerosis in 10% patients, tumors in 6% patients , malformation of cortical development in 3% patients, neurocutaneous syndrome(SWS) identified in 1%, cavernoma in 2% cases, metabolic causes in 3% cases, demyelination in 3% cases and CVT was also found in 3% of cases. Conclusion Our prospective study suggests the importance of MRI in evaluation of underlying brain pathologies causing seizure disorder and age wise most common causes found on MRI brain study, which included cerebrovascular, HIE, infections, mesial temporal sclerosis, tumors, malformation of cortical development, neurocutaneous syndrome, metabolic, vacular malformation and demyelination. We hereby conclude that MRI plays a crucial role in diagnosis and management of patients with seizure disorder by detecting various underlying brain pathologies causing recurrent seizures in epilepsy patients. Study Design: Prospective Study.

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