Magnetic resonance imaging findings in epileptic children and its relation to clinical and demographic findings

Epilepsy is an important disease with a cumulative incidence of 3% all over the life and more than half of them are started from childhood. In this study we surveyed magnetic resonance imaging [MRI] findings in epileptic children and its relation with clinical and demographic findings in order to find better diagnostic and treatment modalities for these children in the future. In this cross sectional study, we investigated consecutively all 1 to 15-year-old epileptic children who referred to the pediatric neurology outpatient clinic from 2004 to 2010. Two hundred children were enrolled for investigation. There were 85 [42.5%] girls and 115 [57.7%] boys, aged 1 to 15-year-old [7.7 +/- 4]. 196 [98%] of the children had abnormal electroencephalography [EEG]. Abnormal MRI was seen in 57 [28.5%] patients and consisted of brain atrophy [10%], increasing white matter signal intensity in T2-weighted images [8%], benign cysts [5%], brain tumors [4%] and vascular abnormalities [1.5%]. Abnormal MRI findings had significant relation with abnormal EEG, age, positive family history for epilepsy, dysmorphic appearance, and abnormal physical exam. Considering 98% EEG abnormalities in these epileptic children, benign nature of MRI findings in most of our cases, the high price of MRI and the small minority of patients who benefit from active intervention as a result of MRI, we suggest to use EEG for confirmation of epilepsy and perform MRI for patient with abnormal physical exams, focal neurologic deficits or focal EEG abnormalities

Thyroid function in epileptic children who receive carbamazepine, primidone, phenobarbital and valproic acid

In this study, we investigated the changes of the serum levels of thyroidhormones including Thyroxine [T4], Triiodothyronine [T3], T3 resin uptake andThyroid stimulating hormone [TSH] in epileptic children during treatment withanti-epileptic drugs [AEDs] including carbamazepine [CBZ], primidone [PRM],phenobarbital and valproic acid [VPA]. This study consisted of four case-series comparisons, was conducted on 115epileptic children [37 girls and 78 boys with an age range between 2 months and 15 years, mean: 62.06 A +/- 44.97 months]. These children were divided into4 groups who took either phenobarbital [n=29], PRM [n=28], CBZ [n=29], or VPA [n=29] for 3 months. Thyroid hormone levels [T3, T3 resin uptake, T4 and TSH] were measured at the beginning and three months after starting the study. At first, all patients were euthyroid and there were no clinical or laboratory findings suggestive of hypothyroidism. Regarding thyroid hormones before and after the administration of phenobarbital, carbamazepine, valproic acid and primidone, there were no significant changes in serum T3, T4, T3 resin uptake and TSH levels. Our findings showed that short term therapy with phenobarbital, carbamazepine, valproic acid and primidone had no effect on thyroid function tests