Neuroimaging of Early Life Epilepsy

被引：24

作者：

Coryell, Jason ^{[1
,2
]}

Gaillard, William D. ^{[3
,4
]}

Shellhaas, Renee A. ^{[5
]}

Grinspan, Zachary M. ^{[6
,7
]}

Wirrell, Elaine C. ^{[8
]}

Knupp, Kelly G. ^{[9
]}

Wusthoff, Courtney J. ^{[10
]}

Keator, Cynthia ^{[11
]}

Sullivan, Joseph E. ^{[12
]}

Loddenkemper, Tobias ^{[13
,14
]}

Patel, Anup ^{[15
,16
]}

Chu, Catherine J. ^{[17
]}

Massey, Shavonne ^{[18
,19
,20
]}

Novotny, Edward J., Jr. ^{[21
,22
,23
,24
]}

Saneto, Russel P. ^{[21
]}

Berg, Anne T. ^{[25
,26
]}

机构：

[1] Oregon Hlth & Sci Univ, Dept Pediat, 3181 Sw Sam Jackson Pk Rd, Portland, OR 97201 USA

[2] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA

[3] George Washington Univ, Childrens Natl Hlth Syst, Dept Neurol, Washington, DC 20037 USA

[4] George Washington Univ, Sch Med, Washington, DC USA

[5] Univ Michigan, Dept Pediat, Ann Arbor, MI 48109 USA

[6] Weill Cornell Med, Hlth Informat Technol Evaluat Collaborat, New York, NY USA

[7] New York Presbyterian Hosp, New York, NY USA

[8] Mayo Clin, Dept Neurol, Rochester, MN USA

[9] Univ Colorado, Sch Med, Dept Pediat & Neurol, Anschutz Med Campus, Aurora, CO USA

[10] Stanford Univ, Div Child Neurol, Palo Alto, CA 94304 USA

[11] Cook Childrens Hlth Care Syst, Jane & John Justin Neurosci Ctr, Ft Worth, TX USA

[12] Univ Calif San Francisco, Dept Neurol, San Francisco, CA USA

[13] Harvard Univ, Boston Childrens Hosp, Div Epilepsy & Clin Neurophysiol, Boston, MA 02115 USA

[14] Harvard Univ, Harvard Med Sch, Boston, MA 02115 USA

[15] Ohio State Univ, Dept Pediat, Columbus, OH 43210 USA

[16] Nationwide Childrens Hosp, Columbus, OH USA

[17] Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USA

[18] Univ Penn, Dept Neurol, Perelman Sch Med, Philadelphia, PA 19104 USA

[19] Univ Penn, Dept Pediat, Perelman Sch Med, Philadelphia, PA 19104 USA

[20] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[21] Seattle Childrens Hosp, Seattle Childrens Res Inst, Div Pediat Neurol, Dept Neurol, Seattle, WA USA

[22] Seattle Childrens Hosp, Seattle Childrens Res Inst, Dept Pediat, Seattle, WA USA

[23] Seattle Childrens Hosp, Seattle Childrens Res Inst, Ctr Integrat Brain Res, Seattle, WA USA

[24] Univ Washington, Seattle, WA 98195 USA

[25] Northwestern Univ, Ann & Robert H Lurie Childrens Hosp Chicago, Epilepsy Ctr, Chicago, IL 60611 USA

[26] Northwestern Univ, Dept Pediat, Feinberg Sch Med, Chicago, IL 60611 USA

来源：

PEDIATRICS | 2018年 / 142卷 / 03期

关键词：

NEWLY-DIAGNOSED EPILEPSY; PEDIATRIC EPILEPSY; SURGICAL-TREATMENT; FOCAL EPILEPSY; CHILDREN; SEIZURES; ONSET; CHILDHOOD; INFANTS; ENCEPHALOPATHY;

D O I：

10.1542/peds.2018-0672

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

OBJECTIVES: We assessed the adherence to neuroimaging guidelines and the diagnostically relevant yield of neuroimaging in newly presenting early life epilepsy (ELE). METHODS: There were 775 children with a new diagnosis of epilepsy (< 3 years old at onset) who were recruited through the ELE study at 17 US pediatric epilepsy centers (2012-2015) and managed prospectively for 1 year. The data were analyzed to assess the proportion of children who underwent neuroimaging, the type of neuroimaging, and abnormalities. RESULTS: Of 725 children (93.5%) with neuroimaging, 714 had an MRI (87% with seizure protocols) and 11 had computed tomography or ultrasound only. Etiologically relevant abnormalities were present in 290 individuals (40%) and included: an acquired injury in 97 (13.4%), malformations of cortical development in 56 (7.7%), and other diffuse disorders of brain development in 51 (7.0%). Neuroimaging was abnormal in 160 of 262 (61%) children with abnormal development at diagnosis versus 113 of 463 (24%) children with typical development. Neuroimaging abnormalities were most common in association with focal seizure semiology (40%), spasms (47%), or unclear semiology (42%). In children without spasms or focal semiology with typical development, 29 of 185 (16%) had imaging abnormalities. Pathogenic genetic variants were identified in 53 of 121 (44%) children with abnormal neuroimaging in whom genetic testing was performed. CONCLUSIONS: Structural abnormalities occur commonly in ELE, and adherence to neuroimaging guidelines is high at US pediatric epilepsy centers. These data support the universal adoption of imaging guidelines because the yield is substantially high, even in the lowest risk group.

引用

页数：9

共 34 条

[1] Incidence and Prevalence of Childhood Epilepsy: A Nationwide Cohort Study [J].