Davagnanam, I;
Chen, Z;
Hoskote, C;
Ding, D;
Yang, B;
Wang, Y;
Wang, T;
... Kwan, P; + view all
(2020)
Prevalence of MRI abnormalities in people with epilepsy in rural China.
Neurology
, 95
(9)
e1236-e1243.
10.1212/WNL.0000000000010171.
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Abstract
OBJECTIVE: To assess the prevalence of brain MRI abnormalities in people with epilepsy in rural China and to compare this with individuals in the United Kingdom. METHODS: Brain MRI scans were obtained in people with epilepsy who participated in a rural community-based program in China between July 2010 and December 2012. Individual epileptogenic lesion types were reviewed and their associations with seizure control examined. The MRI findings were compared with two previous similar studies in the United Kingdom. RESULTS: Among the 597 individuals (58% males; median age 38 years) with MRI scans analyzed, 488 (82%) had active epilepsy. The MRI was abnormal in 389 subjects (65%), with potentially epileptogenic lesion in 224 (38%) and non-specific abnormalities in 165 (28%), and 108 (18%) were potentially resectable. The potentially epileptogenic lesions were less frequently detected in children (<18 years old, 12/68, 18%) than in adults (212/529, 40%; p<0.001). In people with potentially epileptogenic lesions 67% (150/224) had failed two or more antiseizure medications. They had higher risk of uncontrolled epilepsy than those with normal MRI (risk ratio [RR]=1.25; p<0.001) and those with non-specific abnormality (RR=1.15; p=0.002), after adjusting for age and sex. The diagnostic yield of MRI was similar to that reported in community- and hospital-based studies in the United Kingdom. CONCLUSIONS: Over one-third of people with chronic epilepsy in rural China have potentially epileptogenic lesions identifiable on brain MRI, with two-thirds fulfilling the definition of pharmacoresistance. These findings highlight the magnitude of the unmet needs for epilepsy surgery in China.
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