Altraciones tomográficas cerebrales en niños/as epilépticos y su relación con las características clínicas de la enfermedad. Hospital Roberto Gilbert, 2013 - 2015.

Abstract

Background: Epilepsy is a common disease in children. Its diagnosis is clinical and requires complementary studies. The prevalence of abnormal findings in brain computed tomography (CT) in epilepsy is high. CT allows to quickly identify these lesions with acceptable risks. Objectives: To define the prevalence of abnormal findings on brain CT in children with epilepsy and its relation with the clinical features of the disease. Materials and methods: Children from 28 days to 10 years of age, with diagnosis of epilepsy and attended at the “Roberto Gilbert Hospital” between January 2013 and December 2015 were studied. We chose patients with one or several simple or contrasted tomographies. Results: From a total of 254 patients, 156 with a confirmed diagnosis of epilepsy and eligibility criteria, were studied. The prevalence of abnormal findings on CT scans was 51.9%. The most common finding was cortical atrophy(23.7%). Abnormalities were more frequent in children under 2 years (42%), and patients with generalized seizures (59.3%). In infants a 2.7 times greater risk of presenting alterations compared with other ages was found (OR: 2.7 95%CI: 1.3-5.4). Statistical association was found (p <0.05), between indeterminate seizures (spasms) and abnormal CT (OR: 3.8 95%CI: 1.4-10.0). The positive history of some disorder associated with epilepsy also increased the risk (OR: 4.8 95%CI: 2.1-11.0). Association was also found (p <0.05) between the presence of abnormal CT and the requirment for more than onedrug for the seizures control (OR: 4.4 95%CI: 2.2-8.7). Conclusions: Abnormal brain CT in epileptic children from Ecuador are frequent and most centers in this country do not have access to magnetic resonance imaging (MRI). Therefore, CT remains a fundamental tool in the diagnosis, monitoring and treatment of these patients, especially in infants and children with epileptic spasms in whom abnormal CT scans are more common.