ROLE OF MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE SPECTROSCOPY IN EPILEPTIC CHILDREN WITH A HISTORY OF PERINATAL ASPHYXIA: A COMPREHENSIVE STUDY
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Keywords
Epilepsy, Magnetic resonance imaging, Magnetic resonance spectroscopy, Neuroimaging, Perinatal asphyxia, Seizure, Sequelae
Abstract
Introduction: Perinatal asphyxia (PA) is a significant cause of neurological morbidity, with epilepsy being a common sequel. Advanced neuroimaging techniques like Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS) are crucial for evaluating brain injury in these children. Objective: To characterize the structural and metabolic brain alterations in children with epilepsy and a history of PA. Methods: This cross- sectional study was conducted at Popular Diagnostic Center (Badda), Ibne Sina Diagnostic & Consultation Center (Uttara), Popular Diagnostic Center (Shantinagor), Dhaka, Bangladesh, from July 2018 to December 2019. A total of 153 children with epilepsy and a documented history of PA were enrolled using purposive sampling. All participants underwent detailed clinical evaluation and neuroimaging comprising brain MRI and single- voxel MRS. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 23.0. Results: Analysis of 153 children revealed structural brain abnormalities on MRI in 89.5%, primarily periventricular leukomalacia (41.2%), which correlated with seizure type (p=0.008). MRS showed significant metabolic derangements, including reduced NAA/Cr and elevated Cho/Cr ratios (p<0.001). A lactate peak was detected in 52.3% of those with abnormal MRIs and was strongly associated with drug-resistant epilepsy (p=0.003), indicating severe, ongoing metabolic dysfunction. Conclusion: The combined application of Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy effectively delineates the structural and metabolic sequelae of perinatal asphyxia in the epileptic brain, providing crucial biomarkers for prognosis and management in affected children.
References
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Mahmud Hasan Mostofa Kamal
Assistant professor, Department of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka.
A S M Shahidul Hossain
Consultant, Department of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka.
Mohammad Ali Kabir
Medical Officer, Department of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka.
Jeenat Sabah
Superintendent, Institute of Public Health (IPH), Mohakhali, Dhaka.