NEUROIMAGING OF CHILDREN WITH PARTIAL SEIZURES

The predictive value of abnormal neurological findings on neuroimaging (NI) of children with partial seizures (PS) was studied. The sample c omprised 143 children and adolescents with PS from 1979 to 1996. Fifty patients had the following abnormal NI findings: diffuse atrophy and porencephalic cyst (5.6% each), hemiatrophy, tumors, neurocutaneous sy ndrome brain lesions, and dysgenesis (4.2% each), and arachnoid cyst a nd hydrocephalus (2.1% each). There were significantly more NI abnorma lities among those with simple PS than among the other groups of compl ex PS or PS with secondary generalization. All cases of porencephalic cyst (n = 8), and hemiatrophy (n = 6) were in the hemiparetic group, a ll cases of tumor (n = 6) were in the normal group, while most cases o f diffuse atrophy were in the mentally retarded group. Patients with a bnormal NIs had a significantly earlier age of seizure onset than the others. The chance of finding a treatable abnormality in neuroimaging was 5% for tumors and 2% for arachnoid cysts in the group of patients with PS and normal neurological findings. Neither an abnormality detec ted in a neurological examination nor the type of seizure are predicti ve parameters for suggesting the presence of a resectable brain tumor. All patients with newly diagnosed PS should undergo an MRI.