Magnetic Resonance Imaging of the Brain in Epileptic Pediatric Patients: Review of the Experience in Ramathibodi Hospital
Santip Wongladarom MD*, Jiraporn Laothamatas MD*, Anannit Visudtibhan MD**, Phakjit Sawatsut MD**
Affiliation : * Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ** Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Objective : To review a series of epileptic children referred for MR imaging and correlate the structural
abnormalities from the MRI findings with clinical data and EEG..
Materials and Methods : Retrospective review of MRI of the brain performed in children, aged less than 15
years with epilepsy at Ramathibodi Hospital from January 1999 to December 2002 was done. There were
100 children (57 girls, 43 boys) with epilepsy, age range from one month to 14 years, mean 7 years and 5
months. Diagnosis of seizure type and epilepsy were classified according to clinical presentation and EEG..
Results : There were 16 children with primary generalized seizure, 79 children with partial or complex
partial seizures with or without secondary generalization. The remaining 5 children had a specific syndrome.
The most common etiology of all patients was congenital disease, especially cortical dysplasia. Among
children with partial with or without generalization, cortical dysplasia was the most common finding (31%).
Mesial temporal sclerosis and combined cortical dysplasia with mesial temporal sclerosis were found in
24% and 13.9%, respectively. Most of the disease categories showed significant concordance of the EEG to
the MRI findings, except infectious disease.
Conclusion : The most common etiology of epilepsy in children under 15 years old was cortical dysplasia.
For children with partial or complex partial seizure, cortical dysplasia was the most common etiology
followed by mesial temporal sclerosis and combined cortical dysplasia with mesial temporal sclerosis,
respectively. MRI provides precise etiologic classifications of epilepsy..
Keywords : MRI brain, Epileptic pediatric patient, EEG
