Brain MRI Patterns in Pediatric Patients with Epilepsy

Open Access

Abstract

Background: Epilepsy is a common neurological disorder in children, often associated with identifiable structural brain abnormalities. Magnetic Resonance Imaging (MRI) is a critical tool for detecting these lesions, which can guide diagnosis, management, and prognosis. Local data on the spectrum of MRI findings in pediatric epilepsy patients in Bangladesh remains limited. Objective: To determine the frequency and patterns of brain MRI abnormalities in pediatric epilepsy patients. Methods & Materials: A prospective cohort study was conducted at the Department of Radiology & Imaging, Shaheed Tajuddin Ahmad Medical College & Hospital, Gazipur, Bangladesh, from September 2024 to August 2025. A purposive sample of 43 pediatric epilepsy patients was recruited. All participants underwent a dedicated 1.5 Tesla brain MRI protocol for epilepsy. Clinical and neuroimaging data were analyzed using SPSS version 23.0, with descriptive statistics presented as frequencies and percentages. Result: Analysis of 43 patients revealed abnormal brain MRI findings in 72.1% (n=31). Hippocampal sclerosis was the most common pattern (20.9%), followed by malformations of cortical development (16.3%). Abnormal MRI findings showed a significant association with focal-onset seizures (88.9%; p=0.018) and a younger mean age at seizure onset (4.2 years vs. 7.1 years in normal MRI; p=0.012). Conclusion: This study confirms a high yield of abnormal MRI findings in pediatric epilepsy, predominantly hippocampal sclerosis. Dedicated neuroimaging is essential for identifying structural etiologies, guiding targeted management, and optimizing outcomes, especially for children with focal seizures or early onset.