Case Series
Role of Neuroimaging in Paediatric Seizure Disorders: A Case Series
Akhil. M. Kulkarni1,2, Vishal Uttarkar2 and Suhasini Vittal Rao1*
1Consultant fetal medicine specialist, Davangere Scan Centre, Davangere, Karnataka, India.
2Department of Radiology, SSIMS and RC, Davangere, Karnataka, India.
2Department of Radiology, SSIMS and RC, Davangere, Karnataka, India.
*Corresponding author:Suhasini Vittal Rao, Consultant fetal medicine specialist, Davangere scan centre, Davangere, Karnataka, India. E-mail Id: drsuhasini2010@gmail.com
Copyright: © 2025 Kulkarni AM, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article Information: Submission:08/06/2025; Accepted: 02/08/2025; Published: 06/08/2025
Abstract
Background: Seizures in paediatric patients are often due to structural brain abnormalities. Neuroimaging is critical for diagnosis and management.
Methods: We retrospectively reviewed the clinical and neuroimaging data of 昀椀ve pediatric patients with drug-resistant seizures. Imaging studies (CT or MRI) were analyzed to identify features that guided diagnosis and treatment.
Results: Each patient had characteristic neuroimaging findings.
Case 1: A 17-year-old female with focal seizures showed right parietal cortical thickening and a T2-FLAIR transmantle sign on MRI [Figure 1A-C], consistent with focal cortical dysplasia.
Case 2: A 15-year-old boy with infantile spasms and left hemiparesis had right hemispheric ventriculomegaly and cortical dysplasia on CT [Figure 2A-C], indicating hemimegalencephaly.
Case 3: A 13-year-old girl with a facial port-wine stain had left parietal gyriform calcifications and hemiatrophy on CT [Figure 3A-C], diagnosing Sturge-Weber syndrome.
Case 4: A 3-year-old girl with developmental delay had multiple calcified cortical tubers and subependymal nodules on CT, including a mass at the foramen of Monro (Figure 4A–C), consistent with tuberous sclerosis.
Case 5: A 1-year-old girl with new-onset seizures had isolated enlargement of the right lateral ventricle on CT (Figure 5), consistent with unilateral hydrocephalus. In each patient, imaging 昀椀ndings guided targeted management (medical therapy and, when indicated, surgical intervention).
Conclusion: Neuroimaging (MRI and CT) identified the underlying causes of these children’s refractory seizures. MRI revealed subtle cortical and white matter abnormalities, while CT clearly showed calcifications and ventricular anomalies. Recognizing these modality-specific features improves diagnostic accuracy and informs treatment planning.
Methods: We retrospectively reviewed the clinical and neuroimaging data of 昀椀ve pediatric patients with drug-resistant seizures. Imaging studies (CT or MRI) were analyzed to identify features that guided diagnosis and treatment.
Results: Each patient had characteristic neuroimaging findings.
Case 1: A 17-year-old female with focal seizures showed right parietal cortical thickening and a T2-FLAIR transmantle sign on MRI [Figure 1A-C], consistent with focal cortical dysplasia.
Case 2: A 15-year-old boy with infantile spasms and left hemiparesis had right hemispheric ventriculomegaly and cortical dysplasia on CT [Figure 2A-C], indicating hemimegalencephaly.
Case 3: A 13-year-old girl with a facial port-wine stain had left parietal gyriform calcifications and hemiatrophy on CT [Figure 3A-C], diagnosing Sturge-Weber syndrome.
Case 4: A 3-year-old girl with developmental delay had multiple calcified cortical tubers and subependymal nodules on CT, including a mass at the foramen of Monro (Figure 4A–C), consistent with tuberous sclerosis.
Case 5: A 1-year-old girl with new-onset seizures had isolated enlargement of the right lateral ventricle on CT (Figure 5), consistent with unilateral hydrocephalus. In each patient, imaging 昀椀ndings guided targeted management (medical therapy and, when indicated, surgical intervention).
Conclusion: Neuroimaging (MRI and CT) identified the underlying causes of these children’s refractory seizures. MRI revealed subtle cortical and white matter abnormalities, while CT clearly showed calcifications and ventricular anomalies. Recognizing these modality-specific features improves diagnostic accuracy and informs treatment planning.