2025, Vol. 8, Issue 3, Part A

Author(s)
Rafah Amer Mousa and Riyadh Shiltagh Al-Rudaini

Abstract
Background: Epilepsy is a common chronic neurological disorder in children, with a higher burden in low- and middle-income countries like Iraq. Magnetic Resonance Imaging (MRI) plays an essential role in detecting structural brain abnormalities that guide diagnosis, treatment, and surgical planning. Despite the significant burden of pediatric epilepsy in Iraq, local MRI-based data are scarce. This study aimed to describe brain MRI findings in children with epilepsy at the Central Child Teaching Hospital in Baghdad, determine the prevalence and types of detected abnormalities, and assess their clinical associations to support improved management strategies. Methods: A descriptive cross-sectional retrospective study was conducted on brain MRI scans of 280 children aged 1 month to 18 years diagnosed with epilepsy between January and December 2023. Cases with incomplete data, poor-quality scans, or non-epileptic conditions were excluded. Demographic and clinical data, including seizure type, EEG findings, and treatment details, were collected. Two pediatric radiologists independently reviewed and classified MRI findings. Data were analyzed using SPSS version 28.0, with significance set at p<0.05. The main outcome was the prevalence and classification of MRI abnormalities; secondary outcomes assessed correlations with clinical variables. Ethical approval was obtained, and patient confidentiality maintained. Results: Abnormal MRI findings were detected in 61.4% of patients, with malformations of cortical development, acquired lesions, and hippocampal abnormalities being the most common. Focal seizures showed a strong correlation with abnormal MRI results (p<0.05). Significant predictors of abnormal MRI included developmental delay, early seizure onset, poor seizure control, and focal EEG findings. Younger age and drug-resistant epilepsy were also linked to higher abnormality rates. Multivariate analysis confirmed focal seizures and developmental delay as independent predictors. Children with abnormal scans had higher seizure frequency, longer epilepsy duration, and greater surgical referral rates. Conclusions: The high rate of structural brain abnormalities underscores the value of early MRI in pediatric epilepsy care in Baghdad. Clinical factors like seizure type, developmental delay, and EEG patterns can help prioritize neuroimaging, supporting better diagnosis, treatment planning, and seizure control.

DOI: https://doi.org/10.33545/26644436.2025.v8.i3a.472

Pages: 31-40 | Views: 1317 | Downloads: 723