title: A clinical study to identify the possible etiology of complex partial seizures using magnetic resonance imaging brain findings and its implications on treatment.
abstract: BACKGROUND
  Epilepsy is one of the common neurological disorders worldwide. Fundamentally, there are two types of epilepsy-primary generalized epilepsy and localization-related epilepsy. Partial seizures account for about 40% of childhood seizures in some series and can be classified as simple or complex.[1] Partial seizures, more so the complex partial seizures (CPSs), are presumed to have a structural etiology.
  
  
  OBJECTIVE
  (1) To study the magnetic resonance imaging (MRI) brain findings in CPSs in children aged 1-18 years. (2) To identify treatable causes of CPSs based on MRI findings and institute appropriate treatment.
  
  
  METHODS
  Statistical analysis was performed using percentages and proportions.
  
  
  METHODS
  Hospital based prospective study in which MRI brain was done on all newly diagnosed children with complex partial seizures, aged 1 to 18 yrs, during the study period. Final diagnosis was made correlating clinical features, radiological features and other supportive evidences, and appropriate treatment instituted. Follow up of cases was done until the completion of treatment (maximum 6 months).
  
  
  RESULTS
  Among the 64 children who were clinically diagnosed to have CPSs and subjected to MRI study of the brain, 40(62.5%) children were detected to have structural lesions, of which neurocysticercosis (NCC) was noted in 17 (42.5%), tuberculoma in 12 (30%), hippocampal sclerosis (HS) in 6 (15%), gliosis in 4 (10%), and tumor in 1 (2.5%) patient. Sixty-two (96.8%) children were treated medically, and 2 (3.2%) children underwent surgery.
  
  
  CONCLUSIONS
  Etiology of CPS based on MRI findings showed a substantial number of medically- and surgically-treatable pathologies. This study done on South Indian children showed neuro infections to be the most common cause of CPS, followed by HS, with NCC being the most common lesion noted. MRI not only identifies specific epileptogenic substrates, but also determines the specific treatment and predicts prognosis and should be the imaging modality of choice in the evaluation of CPS.
authors.affiliation: Department of Paediatrics, ESIC MC and PGIMSR, Bengaluru, Karnataka, India.
authors.forename: V Nancy
authors.initials: VN
authors.lastname: Jeniffer
authors.affiliation: Department of Paediatrics, ESIC MC and PGIMSR, Bengaluru, Karnataka, India.
authors.forename: S
authors.initials: S
authors.lastname: Udayakumar
authors.affiliation: Department of Paediatrics, ESIC MC and PGIMSR, Bengaluru, Karnataka, India.
authors.forename: K
authors.initials: K
authors.lastname: Pushpalatha
keywords: Etiology of complex partial seizures; hippocampal sclerosis; magnetic resonance imaging brain; neuro-infections; neurocysticercosis; tuberculoma