Evaluation of Magnetic Resonance (MR) Findings in Patients with Refractory Epilepsy

Özet

Objectives: Epilepsy is characterized as a tendency towards recurrent seizures and it is a significant health problem in the worldand one of the most common severe neurologic disorders among children. This study aims to evaluate the outcome of magneticresonance imaging in determining the etiology in patients with refractory epilepsy and to reveal pathologies that may have thepotential to be treated with methods, such as epileptic surgery.Methods: Data were obtained from the patient files of the patients diagnosed with epilepsy and monitored for at least two yearsbetween 01.01.2009-12.31.2012 in the Uludag Faculty of Medicine, the Division of the Pediatric Neurology. File records of the patients,age, sex and MRI findings of the patients were recorded.Results: One hundred twenty were girls (49%) and 125 were male (51%) of the cases. The age range ranged from 1 to 18 years andthe median value was 8.3 (1-18) years. One hundred twenty of the 245 patients who met the diagnostic criteria for resistant epilepsywas found as well controlled. In patients with resistant epilepsy, the findings of these two groups of patients were comparedconcerning MR findings. Among all patients, 154 (62.8%) patients were found to have MR pathology. Of these patients, 83 (53.9%)were in the resistant group and 71 (46.1%) were in the well-controlled group. There was no significant difference in the presence ofMR findings between the two groups (p=0.354). The highest incidence (24.8%) of the encephalomalacia in patients in the resistantgroup may explain the association of perinatal hypoxia with resistance development.Conclusion: If patients with epilepsy can be predicted early in the disease, which group of the patients will not respond wellto medical treatment; unlike other patients, different treatment modalities, such as antiepileptic use, vagal nerve stimulation,ketogenic diet and epilepsy surgery, can be applied to this group of the patients. We think that clinicians can guide the planningof treatment of the MR findings.