MRI Findings in Children with the First Unprovoked Seizure Presenting to the Emergency Department; Does Developmental Delay Suggest the Importance of Brain MRI Evaluation?

  • Niloofar Ayoobi-Yazdi ORCID Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Science, Tehran, Iran
  • Mehran Beiraghi-Toosi ORCID Department of Pediatric Neurology, Mashhad University of Medical Science, Mashhad, Iran
  • Farzad Ashrafi ORCID Mail Department of Neurology, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
  • Atena Aliabadi ORCID Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Science, Tehran, Iran
  • Mehran Arab-Ahmadi ORCID Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Science, Tehran, Iran
Keywords:
Emergency Service, Hospital, Magnetic Resonance Imaging, Pediatrics, Seizures

Abstract

Introduction: The first unprovoked seizure (FUS) in children is a convulsive seizure with an unknown cause, which may be due to an underlying neurological disease or a manifestation of epilepsy. Objective: The aim of this study was to evaluate the findings of brain magnetic resonance imaging (MRI) in pediatric patients with FUS, presenting to the emergency department (ED). Methods: In this cross-sectional study, all children with FUS (age: >1month and<14 years), who were referred to the ED of Qaem Hospital, Mashhad, Iran from 2016 to 2019, were investigated. Medical records, brain MRI findings, electroencephalography (EEG) results, and developmental status of children were reviewed retrospectively. Results: The brain MRI findings of 56 children with FUS were reviewed. The mean age of children was 3.92±6.05 years, and the sex distribution was equal. Seventeen (30.4%) patients had abnormal EEG findings, while 13 (23.2%) patients’ had non-specific EEG findings. Neurological examination of 4 (7.1%) children was abnormal. Overall, 6 (10.7%) patients had non-specific abnormal brain MRI findings for seizure, while 3 (5.4%) patients had specific abnormal findings. A significant relationship was observed between the developmental status of children and abnormal MRI findings (P=0.04). However, MRI findings had no significant relationship with EEG or neurological findings (P>0.05). Conclusion: It may be useful to perform brain MRI for children with FUS presenting to ED, especially those who are suspected of developmental disorders.

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Published
2020-02-17
How to Cite
1.
Ayoobi-Yazdi N, Beiraghi-Toosi M, Ashrafi F, Aliabadi A, Arab-Ahmadi M. MRI Findings in Children with the First Unprovoked Seizure Presenting to the Emergency Department; Does Developmental Delay Suggest the Importance of Brain MRI Evaluation?. Adv J Emerg Med. 4(3):e75.
Section
Original article

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