Magnetic Resonance Imaging findings in pediatric patients with Epilepsy: a single-center experience from Pakistan

OBJECTIVE: To determine the structural abnormalities on magnetic resonance imaging (MRI) in the epileptic Pakistani pediatric population presenting at Tertiary Care Hospital, Karachi. METHODS: This cross-sectional descriptive study was done at the CT 59.5%), followed by focal seizures (n=57; 33%), and unknown seizure patterns (n=13; 7.5%). MRI findings were unremarkable in 68 (39.3%) cases, predominantly in both generalized (35.84%) and focal (2.31%) epilepsy cases. Structural abnormalities were evident in 105 (60.7%) patients on MRI. Cerebral atrophy was predominant (11.56%), especially in generalized epilepsy cases. Encephalomalacia (6.94%) and ventricular enlargement (6.36%) were observed, with encephalomalacia more prevalent in focal epilepsy and ventricular enlargement in generalized epilepsy. Mesial temporal sclerosis (5.7%) was significant in focal epilepsy cases. The highest prevalence of unremarkable MRI findings was in the 6-10 years' age group (20.2%). CONCLUSION: MRI detected abnormalities in 60.7% cases of paediatric epilepsy, most commonly cerebral atrophy and encephalomalacia, emphasizing MRI's role in assessing epilepsy-related structural changes and the need for targeted interventions.