A Cross-sectional Descriptive Study Of Brain MRI Findings In Patients Presenting With Seizure Disorders. A Study At The Kenyatta National Hospital And The Nairobi Hospital

Abstract

Seizure disorders are a common neurological disorder in Kenya (l,2). The causative factors in seizure aetiology have a very wide variation. The role of neuroimaging in the diagnostic evaluation of patients with seizure disorders is to identify structural abnormalities in potential surgical candidates, assist in classifying the seizure type and determining prognosis (3,4). This study aimed to characterize the possible causative lesions in patients with seizure disorders who had MRI brain scans, to define the spectrum of disease seen and determine the age and sex distribution. This was a bi-centric study carried out over a 5 month period from October 2008 to February 2009 in Nairobi. A total of 151 patients were investigated using a 1.5 Tesla scanner(Phillips Intera TM). The most striking finding was that 61.6% of the scans were abnormal. The MRI findings were varied and included Mesial Temporal Sclerosis(10.6%), infarction(9.3%), tumors(8.6%), infection(7.3%) and atrophy(7.3%). This compared well with other studies, where the commonest abnormalities have been found to be hippocampal sclerosis , atrophy or nonspecific white matter lesions. Other study findings included vascular abnormalities, brain damage and malformations of cortical development. The occurrence of seizure disorders showed a slight male predilection with males constituting 52.3% of the study population. The age group that was affected most by seizure disorders was the 14 to 45 year old age group. The commonest indication for referral was patients on treatment with anti epileptics with recurrent seizures. In these patients the commonest finding was mesial temporal sclerosis. MRI was found to be a useful imaging modality compounded by the use of an epilepsy protocolin the imaging of patients with seizure disorders. This study showed that the disease spectrumdetected by MRI was of greater variation when compared to that detected by CT as seen in an earlier study (13). MRI therefore, has an integral role in the imaging of patients with seizure disorders.The benefits far outweigh the cost implications.