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Prevalence of MRI abnormalities in people with epilepsy in rural China

17 September, 2020

Indran Davagnanam, Zhibin Chen, Chandrashekar Hoskote, Ding Ding, Bin Yang, Yingli Wang, Taiping Wang, Wenling Li, John S. Duncan, Wenzhi Wang, Josemir W. Sander, Patrick Kwan

Neurology September 1, 2020 95 (9). First published July 1, 2020, DOI: https://doi.org/10.1212/WNL.0000000000010171

Objective

To assess the prevalence of brain MRI abnormalities in people with epilepsy in rural China and to compare it with that of 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 2 previous similar studies in the United Kingdom.

Results

Among the 597 individuals (58% male, median age 38 years) with MRI scans analyzed, 488 (82%) had active epilepsy. The MRI was abnormal in 389 individuals (65%), with potentially epileptogenic lesion in 224 (38%) and nonspecific abnormalities in 165 (28%), and 108 (18%) were potentially resectable. The potentially epileptogenic lesions were less frequently detected in children (

Conclusions

More than 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.