ĐẶC ĐIỂM LÂM SÀNG VÀ HÌNH ẢNH CỘNG HƯỞNG TỪ Ở BỆNH NHÂN ĐỘNG KINH KHỞI PHÁT TRƯỚC 1 TUỔI TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objective: To analyze brain magnetic resonance imaging (MRI) in patients with epilepsy onset before 1 year of age, thereby clarifying the role of MRI in detecting structural lesions causing epilepsy in this pediatric population. Methods: This cross-sectional study describes the clinical and MRI characteristics of 109 children under 3 years old diagnosed with epilepsy onset before 1 year at the National Children’s Hospital from June 2024 to May 2025. Results: The mean age at seizure onset was 5.54 ± 3.5 months, and 60.6% of patients were male. Generalized epilepsy was the most common type, accounting for 43.1%, while focal and unclassified epilepsy accounted for 29.4% and 27.5%, respectively. A total of 87.2% of patients had psychomotor developmental delay, including 40.4% with mild to moderate delay and 46.8% with severe delay. MRI abnormalities were detected in 85.3% of cases, including 26.6% developmental abnormalities, 33.9% acquired lesions, and 24,8% non-specific lesions. There was a significant association between severe developmental delay and the type of MRI lesion (p = 0.041). Conclusions: Children with epilepsy onset before 1 year of age often have structural brain abnormalities associated with psychomotor developmental delay, and brain MRI combined with genetic and metabolic testing helps to identify the underlying cause accurately and guide early intervention.