Brain magnetic resonance imaging findings and their relationship with prognosis in children with focal epileptic encephalographic discharges

Le résumé fourni par la source

Objective: This study aimed to evaluate the relationship between normal brain magnetic resonance imaging (MRI) findings and prognosis in children with focal epileptic disorder on electroencephalography (EEG) without an epileptic syndrome. Material and Methods: Data from patients aged 0-18 years, who were followed up with a diagnosis of epilepsy at the pediatric neurology clinics over the last 5 years, were retrospectively reviewed. Patients with focal epileptic disorder on EEG were selected. Those with an epileptic syndrome were excluded from the study. The patients’ demographic characteristics, seizure types, etiologies, brain MRI findings, seizure focus, treatment methods, and seizure control were analyzed. Patients were divided into two groups based on their brain MRI findings (normal and abnormal) and compared in terms of treatment resistance, number of medications, and seizure control. Results: The mean age of the 100 patients included in the study was 8±4.32 years, with an equal gender distribution (50% female, 50% male). Generalized seizures were observed in 72% of patients, while 28% had focal seizures. Seizure freedom was achieved in 60% of cases, and treatment resistance was noted in 23%. Cranial MRI revealed structural abnormalities in 67% of patients, with the majority (84%) showing sequelae-related changes, including hypoxic-ischemic sequelae (16%), encephalomalacia (12%), and structural malformations (10%). Although treatment resistance (28.8% vs. 12.1%) was higher and seizure freedom (56.7% vs. 66.7%) was lower in patients with abnormal MRI findings compared to those with normal MRI, these differences were not statistically significant (p =0.150 and p=0.310 respectively) . However, perinatal (p=0.013) and postnatal complications (p=0.042) were significantly more frequent in patients with abnormal MRI findings. Conclusion: In children with focal epileptic disorder on EEG, normal brain MRI findings do not predict a better prognosis in terms of seizure control and treatment resistance. Other factors affecting treatment resistance in this population need to be investigated in more detail.

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