Cross-sectional Study on Patterns of Brain MRI Findings in Patients with Epilepsy Seen in the Neuro Radiology Unit at Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
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Date
2018-10
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Addis Ababa UniversIty
Abstract
Background: Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures. It can result from inherited (genetic) or acquired factors or a combination of both. Important causes include infections, head trauma, vascular malformations, brain tumors and stroke. MRI can diagnose these wide varieties of pathologic lesions routinely and noninvasively.
Objective: The objective of this study is to assess the patterns of brain MRI findings in patients with epilepsy.
Method: A cross-sectional study was conducted at Tikur Anbessa Specialized Hospital(TASH) among patients with epilepsy evaluated at neuroradiology unit from August 2016 to December 2017.All patients who fulfill the International League Against Epilepsy (ILEA) criteria of epilepsy and who had brain imaging done on a 1.5T MRI machine with standard epilepsy protocol were included in this study. Data were collected by using structured data collection format, analyzed using SPSS version 20.0 software and results were displayed using descriptive statistics.
Results: A total of 378 patients had brain MRI done at the radiology unit for the clinical indication of seizure during the study period. Among whom 132 patients who had at least one epileptic seizure, who had their brain MRI done on standard epilepsy protocol and whose charts were retrievable were included in this study. Out of the included patients 79(59.8%) were male, 50 (40.2%) were female, 59 (44.7%) were in the under 10 age group and more than two thirds of all patients were aged less than 20 years. The commonest type of seizure reported in this study was generalized tonic clonic seizure (GTC) accounting for 98 (74.2%) of the cases and 50(37.9%) of the patients had their first seizure between the age of 1-10. Abnormalities were detected on the brain MRI in about half 64 (48.5%) of the cases.
The commonest brain abnormality detected in this study was gliosis/brain parenchymal volume loss which was seen in 29 (45.3%) of the cases. The other abnormalities seen include mesial temporal sclerosis 8(12.5%) and brain tumor 8(12.5%). The commonest cause of gliotic change identified was perinatal injury 12(41.4%) and 18(62%) of the gliotic lesions were seen among children aged less than 10 years.
Conclusion: In this study, young people aged less than 20years were more affected by epilepsy where GTC was the commonest seizure type. Gliosis or brain parenchymal volume loss predominantly caused by perinatal injury was the commonest type of brain abnormality. The other lesions identified included mesial temporal sclerosis, brain tumors, infections and cortical malformations.
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Epilepsy, TASH, MRI, Gliosis, Perinatal injury