Abstract
Objective : To identify the pattern of intracranial structural lesions in developmentally normal children with partial motor seizures by computed tomography and to monitor the behavior of single ring enhancing lesion (SREL) after a period of time with or without treatment.Methods: Consecutive developmentally normal children between one year and twelve years with partial motor seizures in a tertiary care referral Hospital. After clinical examination and appropriate investigation for tuberculosis and cysticercosis, CT scan was performed. In addition to anticonvulsants, children received antituberculous or anticysticercal therapy if indicated. Repeat CT was performed on children with SREL after 6 months.Results: Computed tomography was abnormal in 102 (68%) children. Majority of the children (75) had SREL. The lesions were located in decreasing order of frequency in the parietal lobe (65), frontal lobe (7), occipital lobe (1), temporal lobe (1) and cerebellum (1). Repeat CT scan was performed on 50 of the 75 children with SREL. Among these, in 41 children who were only on antiepileptic therapy, the SREL had decreased in size in thirty-two whereas in the rest (9), there was no change in the size.Conclusion: Awareness of the existence of disappearing SREL lesions is essential to avoid unnecessary treatment with antituberculous or anticysticercal therapy and provides ample justification in treating with anticonvulsant drugs only
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Cowan L, Bodeasteiner J, Leviton A, Doherty L. Prevalence of epilepsies in children and adolescent.Epilepsia 1989; 30: 94–106
Alving J. Classification of epilepsies: an investigation of 402 children.Acta Neurol Scand 1979; 60:157–163.
Al-Sulaiman AA, Ismail HM. Clinical pattern of newly diagnosed seizures in Saudi Arabia: a prospective study of 263 children.Childs Nerv Syst 1999; 15:468–471.
Fritsch G, Ebner F, Schneider G. Computed tomography in partial epilepsies in childhood.Eur Neurol 1988; 28:306–310.
Kapoor M, Talukdar B, Chowdhury V, Puri V, Rath B. Intracranial structural lesions in young epileptics:A Computed Tomographic Study 1997; 35:537–541.
Rajshekhar V, Haran RP, Prakash GS, Chandy MJ. Differentiating solitary small cysticercus granulomas and tuberculomas in patients with epilepsy. Clinical and computerized tomographic criteria.J Neurosurg 1993; 78:402–407.
Del Brutto UH, Rajasekhar V, White Jr ACet al. Proposed diagnostic criteria for neurocysticercosis.Neurology 2001; 57: 177–183.
Kwong KL, Chak WK, Wong SN, So KT. Epidemiology of childhood epilepsy in a cohort of 309 Chinese children.Pediatr Neurol 2001; 24:276–282.
Commission on classification and Terminology of the International League Against Epilepsy. Proposal for Revised classification of the epilepsies and epileptic syndromes.Epilepsia 1989; 30:389–399.
Morton LD, Pellock JM. Diagnosis and treatment of epilepsy in children and adolescents.Drugs 1996; 51:399–414.
Singhi S, Singhi PD, Walia BNS. Clinical profile and etiology of partial seizures in Chandigarh children.Epilepsia 1990; 31S: 666–667.
Bajaj S, Barthwal SP, Dwivedi NC, Maheshwari AK, Goel UC. Contrast computed tomography in epilepsy with special reference to intracranial ring or disc enhancing lesions.J Assoc Physicians India 1991; 39:543–545.
Garg RK, Nag D. Single enhancing CT lesions in Indian patients with seizures: clinical and radiological evaluation and follow-up.J Trop Pediatr 1998; 44:204–210.
Kramer U, Nevo Y, Reider-Groswasser Iet al. Neuroimaging of children with partial seizures.Seizure 1998; 7:115–118.
Endziniene MV, Miseviciene PI. Prevalence of childhood epilepsy in Kaunas, Lithuania.Brain Dev 1997; 19:379–387.
Sidenvall R, Forsgren L, Heijbel J. Prevalence and characteristics of epilepsy in children in northern Sweden.Seizure 1996; 5:139–146.
Wadia RS, Makle CN, Kelkar AV, Grant KB. Focal epilepsy in India with special reference to lesions showing ring or disc like enhancement on contrast computed tomography.J Neurol Neurosurg Psychiatry 1987; 50:1298–1301.
Sethi PK, Kumar BR, Madan VS, Mohan V. Appearing and disappearing CT scan abnormalities and seizures.J Neurol Neurosurg Psychiatry 1985; 48: 866–869.
Bhargava S, Tandon PN. Intracranial tuberculoma: A CT study.Br J Radiol 1980; 53:935–945.
Chandy MJ, Rajshekhar V, Ghosh Set al. Single small enhancing CT lesions in Indian patients with epilepsy: clinical, radiological and pathological considerations.J Neurol Neurosurg Psychiatry 1991; 54: 702–705.
Kumar GR, Kumar SM, Misra S. Single-enhancing CT lesions in Indian patients with seizures: a review.Epilepsy Res 2000; 38: 91–104.
Baranwal AK, Singhi PD, Khandelwal N, Singhi SC. Morphometry of single small enhancing computed tomographic lesions: outcome and effect of albendazole therapy.J Trop Pediatr 2002; 48:219–224.
Baranwal AK, Singhi PD, Khandelwal N, Singhi SC. Albendazole therapy in children with focal seizures and single small enhancing computed tomographic lesions: a randomized, placebo-controlled, double blind trial.Pediatr Infect Dis J 1998; 17:696–700.
Gupta M; Agarwal P, Khwaja GAet al. Randomized prospective study of outcome of short term antiepileptic treatment in small single enhancing CT lesion in brain.Neurol India 2002; 50:145–147.
Kennedy A, Schon F. Epilepsy: disappearing lesions appearing in the United Kingdom.BMJ 1991; 302:933–935.
Bansal BC, Dua A, Gupta R, Gupta MS. Appearing and disappearing CT scan abnormalities in epilepsy in India—an enigma.J Neurol Neurosurg Psychiatry 1989; 52:1185–1187.
Goulatia RK, Verma A, Mishra NK, Ahuja GK. Disappearing CT lesions in epilepsy.Epilepsia 1987; 28: 523–527.
Jha SK, Dougall P, Behari M, Ahuja GK. Interictal brain 99m Tc-HMPAO SPECT study in cases of epilepsy with single ring enhancing CT lesion.J AssocPhysicians India 2000; 48:382–385.
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Hussain, J., Srinivasan, S., Tiroumourougane Serane, V. et al. Cranial computed tomography in partial motor seizures. Indian J Pediatr 71, 641–644 (2004). https://doi.org/10.1007/BF02724126
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DOI: https://doi.org/10.1007/BF02724126