Utility of Gadolinium-Based Contrast in Initial Evaluation of Seizures in Children Presenting Emergently

• DOI: 10.3174/ajnr.a7976
• Publication Date: 2023-08-31T16:10:23Z
• Authors: Denas Andrijauskis; Graham Woolf; Alexander Kuehne; Khalid Al-Dasuqi; Cicero T. Silva; Seyedmehdi Payabvash; Ajay Malhotra
• Keywords: Hippocampal sclerosis

<h3>BACKGROUND AND PURPOSE:</h3> The frequency and utility of gadolinium in evaluation acute pediatric seizure presentation is not well known. purpose this study was to assess the gadolinium-based contrast agents MR imaging performed for presentation. <h3>MATERIALS METHODS:</h3> We identified consecutive patients with new-onset seizures from October 1, 2016, September 30, 2021, who presented emergency department and/or were admitted inpatient unit had an brain seizures. clinical data recorded, including patient's age sex, use IV gadolinium, underlying cause epilepsy when available. <h3>RESULTS:</h3> A total 1884 inclusion. Five hundred twenty-four (28%) potential epileptogenic findings on imaging, while 1153 (61%) studies normal 207 (11%) nonspecific signal changes. Epileptogenic subclassified as following: neurodevelopmental lesions, 142 (27%); intracranial hemorrhage (traumatic or germinal matrix), 89 (17%); ischemic/hypoxic, 62 (12%); hippocampal sclerosis, 44 (8%); neoplastic, 38 (7%); immune/infectious, 20 (4%); phakomatoses, 19 vascular anomalies, 17 (3%); metabolic, 3 (&lt;1%); other, 90 (17%). Eight seventy-four (46%) received gadolinium. Of those, only 48 (5%) cases retrospectively deemed have necessitated gadolinium: Fifteen (31%) 33 (69%) neoplastic. 1010 initial noncontrast study, 15 (1.5%) required repeat further evaluate findings. <h3>CONCLUSIONS:</h3> Gadolinium limited additive benefit onset most instances.