Clinical Characteristics and Utility for Seizure Lateralization of Venous Engorgement on Brain MRI in Pediatric Patients with Seizures
Abstract number :
2.224
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2024
Submission ID :
166
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Juhyun Kong, MD – Pusan National University Children's Hospital
Sooyoung Lyu, MD – Pusan National University Children's Hospital
Sang Ook Nam, MD, PhD – Pusan National University Children's Hospital
Yun-Jin Lee, MD – Pusan National University Children's Hospital
Rationale:
Susceptibility-weighted imaging (SWI) in MRI effectively demonstrates cerebral venous engorgement, obseved in several pathological states. We observed such changes in patients who underwent brain MRI immediately following seizures. This study aims to reveal the clinical characteristics of patients showing these changes on SWI and to explore the clinical utility of these findings, particularly in the lateralization of seizures.
Methods:
We enrolled pediatric patients aged 1 to 18 years who visited the emergency room (ER) due to seizures and underwent brain MRI within 48 hours of seizure onset at Pusan National University Children’s Hospital between March 2017 and June 2019. We excluded patients with conditions affecting cerebral blood flow, such as meningoencephalitis, cerebral vascular insults, and metabolic diseases. We collected clinical information retrospectively and compared two groups: those with and without VE on SWI.
Results: Among the 109 patients, group A (with VE) included 36 patients (33%), and group B (without VE) included 73 patients (67%). The age was higher in group A, with an average of 5.47 ± 3.61 years, compared to 3.76 ± 2.80 years in group B (p=0.008). Prolonged seizures lasting over 15 minutes were more frequent in group A (n=9, 25%, p=0.004). Among the 50 patients with focal onset seizures, seizure lateralization was possible through seizure semiology and EEG findings in 31 patients (62%). However, lateralization increased to 37 patients (74%) when VE on SWI was also considered.
Conclusions:
Patients who exhibited VE on brain MRI within 48 hours of seizure onset had a higher incidence of prolonged seizures and shorter intervals between seizure onset and MRI. Additionally, considering the findings of venous engorgement made the lateralization of the epileptogenic focus more predictable.
Funding:
No external funding was received in support of this abstract.
Clinical Epilepsy