neuroimaging findings in first unprovoked seizures: a multicentric study in tehran

how to cite this article : molla mohammadi m, tonekaboni sh, khatami ar, azargashb e, tavasoli a, javadzadeh m, zamani gr. neuroimaging findings in first unprovoked seizures: a multicentric study in tehran. iran j child neurol. 2013 autumn; 7(4):24-31. objective seizure is an emergency in pediatrics. it really matters to the parents of the involved child to have information about the causes, management and prognosis. first unprovoked seizures (fus) are seizures that occur in patients without fever, trauma or infection. due to the rapid improvement in diagnostic techniques in the last few decades, the etiology will be revealed and this term will no longer exist. this study was designed to evaluate brain imaging findings in fus patients.   materials & methods ninety-six children with fus, who were admitted in three major children’s hospitals in tehran, underwent brain imaging and were enrolled into the study. the decision about the type of imaging (ct or mri) was based on the patient’s medical and financial conditions. an expert radiologist in the field of pediatric neuroimaging interpreted the images.   results altogether, 27.1% had abnormal findings of which 29.2% were in the brain mri group and 14.3% were in the brain ct scan group. abnormal results were gliosis (10.4%), hemorrhage (4.2%), dysgenesis (2.1%), dysmyelination (7.3%), encephalomalacy (1%), atrophy (5.2%) and infarction (2.1%). in some patients, the lesions were in 2 or 3 sites and some had more than one type of lesion. there was no association between the duration, age and type of seizure and imaging abnormlities. however, we found an association between the location of the lesion and the type of seizure.   conclusion we recommend brain imaging in all patients with fus and apart from some exceptions, brain mri is superior to ct.   references johnston mv. siezure in childhood. in: kliegman rm, behrman re, editors. nelson text book of pediatrics. 18 th ed. philadelphia: saunders; 2010. p. 2457-70. bluestein js, moshe sl. first unprovoked seizure. in: maria bl, editor. currents in management in child neurology. 3rd ed. hamilton: bc decker; 2005. p. 89-92. khodapanahandeh f, hadizadeh h. neuroimaging in children with first afebrile seizures: to order or not to order? arch iran med 2006 apr;9(2):156-8. alawaneh h, bataineh ha. urgent neuroimaging in children with first nonfebrile seizures. middle east jfam med 2008 feb;6(1):24-6. shinnar s, o’dell c, mitnick r, berg at, moshe sl. neuroimaging abnormalities in children with an apparent first unprovoked seizure. epilepsy res 2001 mar;43(3):261-9. kalnin aj, fastenau ps, degrauw tj, musick bs, perkins sm, johnson cs, et al. magnetic resonance imaging findings in children with a first recognized seizure. pediatr neurol 2008 dec;39(6):404-14. king ma, newton mr, jackson gd, fitt gj, mitchell la, silvapulle mj et al. epileptology of the first-seizure presentation: a clinical, electroencephalographic, and magnetic resonance imaging study of 300 consecutive patients. lancet 1998 sep 26;352(9133):1007-11. pohlmann-eden b, beghi e, carnfieldc, carnfield p. the first seizure and its management in adults and children. bmj 2006 feb;332(11):339-34. raman s, susan k, joyce w. paroxysmal disorders.in: menkes j, editor. child neurology. 7th ed. philadelphia: lipincott; 2006. p. 857-942. wical b. the first unprovoked seizure.gillette children’sspecialty healthcare. a pediatricperspective 1999 mar;8(3). bano s, yadav sn.neuroimaging in epilepsy.medi-focus2010 apr-sep;9(3&4):2-4. rauch da,carr e, harrington j.inpatient brain mri for new-onset seizures: utility and cost effectiveness.clin pediatr (phila) 2008 jun;47(5):457-60. gaillard wd, chiron c, cross jh, harvey as, kuzniecky r, hertz-pannier l et al. guidelines for imaging infants and children with recent-onset epilepsy. epilepsia 2009 sep;50(9):2147-53. barkovich aj. techniques and methods in pediatric neuroimaging. 4thed. philadelphia: lippincott williams &wilkins; 2005. p. 4-7. doescher js, degrauw tj, musick bs, dunn dw, kalnin aj, egelhoff jc et al. magnetic resonance imaging and electroencephalic findings in a cohort of normal children with newly dignosed seizures. j child neurol 2006 jun; 21(6):490-5.