Correlation between clinical characteristics, brain magnetic resonance imaging, and electroencephalographic findings in children with myoclonic epilepsy: a cross-sectional study

Abstract Background Myoclonic epilepsy is a heterogeneous group of pediatric epilepsies with variable clinical, EEG, and MRI findings. Data from Egyptian children are limited. Objective To describe the clinical, EEG, and MRI features of Egyptian children with myoclonic epilepsy and examine their relation to seizure burden. Methods This cross-sectional study included 60 children diagnosed according to International League Against Epilepsy criteria. All patients underwent clinical assessment, EEG, and brain MRI. Selected genetic and metabolic tests were performed when indicated. Associations were analyzed using chi-square tests, with considered significant when p value ≤ 0.05. Results The median age was 7 years, 67% were boys. Juvenile myoclonic epilepsy was the most common diagnosis (30%), followed by neuronal ceroid lipofuscinosis (28.3%). Developmental delay was present in 28%, generalized myoclonus in 63.3% while daily seizures observed in 55% and EEG abnormalities were frequent, with predominant slow background activity in 51.7%, abnormal brain imaging MRI founded in 63.3%, mostly showing diffuse brain atrophy (38.3%). Abnormal EEG background correlated significantly with brain atrophy. Higher seizure frequency was strongly associated with abnormal EEG background and abnormal MRI. Conclusion EEG background slowing and abnormal MRI are associated with greater seizure burden and severrity of the disease in pediatric myoclonic epilepsy. Combined clinical, EEG, and MRI assessment improves phenotypic stratification and prognostic evaluation.