Brain magnetic resonance imaging findings among paediatric patients with seizure disorders attending Muhimbili National Hospital

Abstract

Background Paediatric seizures are a common problem in developing countries including Tanzania. However little information is available regarding the aetiology of seizures in our society. There are several causes of seizures ranging from congenital, infectious, tumors, vascular to unknown causes where by precise identification is a key to the long term management and control of seizure disorder. MRI is the most advanced crosssectional imaging modality which has enabled identification of several causes of seizure from congenital, infectious, tumours, vascular to structural causes. This study aims to investigate the patterns of MRI findings in children presenting with seizures at Muhimbili National Hospital, Dar es salaam , Tanzania and to characterise the demographic patterns of identified lesions associated with seizures in these children. Broad objective To determine patterns of MRI findings associated with seizure disorders among paediatric patients at Muhimbili National Hospital from June 2016 to December 2016. Methodology This is a descriptive cross sectional study which was conducted at the Radiology department, Muhimbili National Hospital from June to December 2016. Children presenting with seizures referred for brain MRI were included in the study. Consent was obtained for children who met inclusion criteria for the study from their parents/guardians. Formal ethical approval was obtained from the Muhimbili university of Health and Allied Sciences Senate Research and Publications Committee. Structured questionnaires were used for recording patients' demographics, and imaging findings. Data analysis was done using the Statistical Package for Social Sciences (SPSS) version 23. Statistical Association was done by using cross tabulations and Chi-square test was used to compare proportions. P value of < 0.05 was considered statistically significant. Results The median and mean age of the study participants was 6.8 and 5 years respectively with a range of 1 to 17 years . Prevalence of seizures was more in males compared to females (62.9%), and the most affected age group was those below 5 years old. Tonic clonic seizures were the commonest seizure pattern in all age groups observed in this study followed by partial seizures, and status epilepticus. More than half of the seizures (53.2%) were spontaneous. Birth associated problems(birth asyphyxia, trauma), meningitis, and trauma were the commonest risk factors associated with seizure disorder. The most common findings were Infarct (8.1%), encephalomalacia (6.5%), congenital anomalies (4.8%), Gliosis and hydrocephalus (4.8%). There was no significant relationship of these patterns with seizure type observed Conclusion Abnormal findings were found in 41.9% of patients in this study. Although there was a significant number of normal MRI found, investigation of seizures in children is mandatory for proper management planning. Recommendations MRI is a safe and efficient imaging tool, I recommend all children presenting with seizures to be investigated thoroughly using this tool. I reckon for more studies regarding seizures in our society to be done to include bigger sample sizes and multidisciplinary approach.