Neuroimaging in pediatric patients with new-onset status epilepticus
DOI: 10.32364/2587-6821-2022-6-10-596-599
E.A. Kulish1, V.M. Frolova2
1Serpukhovskaya Central Regional Hospital, Serpukhov, Russian Federation
2M.F. Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow, Russian Federation
Status epilepticus (SE) is one of the most common urgent neurological conditions in children. SE occurs as a result of the failure of the mechanisms responsible for stopping seizures, or of those that cause abnormally long seizures. The International League against Epilepsy recommends examining patients with epilepsy (including those with new-onset SE) using neuroimaging methods. In order to assess the informative value of neuroimaging methods in determining the causes of SE, we conducted a retrospective analysis of 44 medical records of pediatric patients with new-onset SE who were admitted in critical condition to the children’s intensive care unit for the period from 2000 to 2019. In the studied sample, only 32 patients were examined using neuroimaging methods (MRI, CT, EEG, video EEG monitoring). In 25% of cases, no changes were detected. The rest revealed epileptogenic (15.3%), conditionally epileptogenic (65.5%) and non-epileptogenic (19.2%) changes. To c larify the etiology of epilepsy in the latter case, it is recommended to conduct additional examination using other diagnostic methods. Thus, the use of neuroimaging methods is an important link in the patient management with new-onset SE.
Keywords: epilepsy, status epilepticus, children, brain, neuroimaging, magnetic resonance imaging, computed tomography.
For citation: Kulish E.A., Frolova V.M. Neuroimaging in pediatric patients with new-onset status epilepticus. Russian Medical Inquiry. 2022;6(10):–599 (in Russ.). DOI: 10.32364/2587-6821-2022-6-10-596-599.
About the authors:
Elena A. Kulish — neurologist of the Serpukhovskaya Central Regional Hospital; 3, Forssa str., Serpukhov, 142201, Russian Federation; ORCID iD 0000-0001-7647-1667.
Victoria M. Frolova — neurologist, post-graduate student of the Department of Neurology, M.F. Vladimirskiy Moscow Regional Research and Clinical Institute; 61/2, Shchepkin str., Moscow, 129110, Russian Federation; ORCID iD 0000-0002-1816-7904.
Contact information: Victoria M. Frolova, e-mail: victoriafroloff@yandex.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 24.01.2022.
Revised 16.02.2022.
Accepted 16.03.2022.
2. Tully I., Draper E.S., Lamming C.R. et al. Admissions to paediatric intensive care units (PICU) with refractory convulsive status epilepticus (RCSE): A two-year multi-centre study. Seizure. 2015;29:153–161. DOI: 10.1016/j.seizure.2015.04.002.
3. Sánchez Fernández I., Abend N., Agadi A. et al. Time from convulsive status epilepticus onset to anticonvulsant administration in children. Neurology. 2015;84:2304–2311.
4. Giovannini G., Kuchukhidze G., McCoy M.R. et al. Neuroimaging alterations related to status epilepticus in an adult population: Definition of MRI findings and clinical-EEG correlation. Epilepsia. 2018;59 Suppl 2:120–127. DOI: 10.1111/epi.14493.
5. Riviello J.J. Jr, Ashwal S., Hirtz D. et al.; American Academy of Neurology Subcommittee; Practice Committee of the Child Neurology Society. Practice parameter: diagnostic assessment of the child with status epilepticus (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2006;67(9):1542–1550. DOI: 10.1212/01.wnl.0000243197.05519.3d.
6. Gaillard W.D., Chiron C., Cross J.H. et al.; ILAE, Committee for Neuroimaging, Subcommittee for Pediatric. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia. 2009;50(9):2147–2153. DOI: 10.1111/j.1528-1167.2009.02075.x.
7. Beghi E., De Maria G., Gobbi G., Veneselli E. Diagnosis and treatment of the first epileptic seizure: guidelines of the Italian League against Epilepsy. Epilepsia. 2006;47(Suppl 5):2–8. DOI: 10.1111/j.1528-1167.2006.00869.x.
8. Зуев В.В., Колоколов О.В., Карась А.Ю., Дробитова А.В. Роль нейровизуализации в стратегии лечения эпилепсии. Саратовский научно-медицинский журнал. 2012;8(2):436–439. [Zuev V.V., Kolokolov O.V., Karas A.U., Drobitova A.V. The role of neuroimaging in the treatment strategy for epilepsy. Saratov Journal of Medical Scientific Research. 2012;8(2):436–439 (in Russ.)].
9. Shaikh Z., Torres A., Takeoka M. Neuroimaging in Pediatric Epilepsy. Brain Sci. 2019;9(8):190. DOI: 10.3390/brainsci9080190.
10. Fiest K.M., Sauro K.M., Wiebe S. et al. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology. 2017;88(3):296–303. DOI: 10.1212/WNL.0000000000003509.
11. Hsieh D.T., Chang T., Tsuchida T.N. et al. New-onset afebrile seizures in infants: role of neuroimaging. Neurology. 2010;74(2):150–156. DOI: 10.1212/WNL.0b013e3181c91847.
12. Алиханов А.А. Визуализация эпилептогенных поражений мозга у детей. М.: Видар-М; 2009. [Alikhanov A.A. Visualization of epileptogenic brain lesions in children. M.: Vidar-M; 2009 (in Russ.)].
13. Meletti S., Monti G., Mirandola L. et al. Neuroimaging of status epilepticus. Epilepsia. 2018;59 Suppl 2:113–119. DOI: 10.1111/epi.14499.
14. Cianfoni A., Caulo M., Cerase A. et al. Seizure‐induced brain lesions: a wide spectrum of variability reversible MRI abnormalities. Eur J Radiol. 2013;82:1964–1972. DOI: 10.1016/j.ejrad.2013.05.020.
15. Cartagena A.M., Young G.B., Lee D.H. et al. Reversible and irreversible cranial MRI findings associated with status epilepticus. Epilepsy Behav. 2014;33:24–30. DOI: 10.1016/j.yebeh.2014.02.003.
16. Huang Y.-C., Weng H.-H., Tsai Y.-T. et al. Periictal magnetic resonance imaging in status epilepticus. Epilepsy Res. 2009;86:72–81. DOI: 10.1016/j.eplepsyres.2009.05.011.
17. Chatzikonstantinou A., Gass A., Förster A. et al. Features of acute DWI abnormalities related to status epilepticus. Epilepsy Res. 2011;97:45–51.
18. Котов А.С., Фирсов К.В. Эпилепсия: руководство для врачей. М.: МИА; 2021. [Kotov A.S., Firsov K.V. Epilepsy: a guide for physicians. M.: MIA; 2021 (in Russ.)].
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