The Agreement Between Long-Term Monitoring by Electroencephalography and Magnetic Resonance Imaging in Paediatric Seizure

Background: Demonstration of high agreement between structural abnormalities identified on magnetic resonance imaging (MRI) and physiologic abnormalities identified on electroencephalography (EEG) could benefit the assessment of epileptic focus in childhood seizures. Objectives: The present study aimed to assess the agreement between abnormal findings on brain MRI and long-term monitoring (LTM) by EEG as the standard protocol in children with abnormal focal epileptic discharges in LTM. Methods: This cross-sectional study was performed on 95 children who suffered from seizures with evidence of focal epileptic discharges in LTM who were referred to the Children's Medical Center in 2017. All patients were also concurrently evaluated by MRI. All MRIs were evaluated twice, before and after receiving the EEG results. Results: In this study, 59 out of 95 patients with abnormal LTM had concurrently abnormal MRI findings. The diagnostic agreement between the MRI and LTM in discovering abnormal findings was found to be high (86.4%) with a kappa correlation coefficient equal to 0.79. Conclusions: About two-thirds of patients with abnormal LTM findings had concurrent abnormal MRI features with high agreement between the two. Thus, MRI and EEG can be valuable in predicting epileptic focus in drug-resistant patients who need surgery.