Structural Abnormalities on MRI in Cases with Epilepsy
Structural Abnormalities on MRI in Epilepsy
Introduction: Many treatable anatomical abnormalities of the brain can cause seizures. The present study was done to determine the role of MRI for evaluation of patients with epilepsy. Subjects and Methods: Patients who presented to our hospital with history of epilepsy. i.e two or more episodes of unproved seizures 24 hours apart, underwent MRI study to assess for abnormalities. Patients of either gender and all age groups who were referred to our department for MRI study were included. Results: Generalized tonic clonic seizures were present in 86% of the population and rest had partial seizures. Using MRI, we arrived at a diagnosis as a cause of seizure in 51.3% of the patients and rest of the 48.7% had a normal MRI study. The most common pathology detected on MRI was infarct with gliosis (24.7%). Less common pathology detected were neurocysticercosis (6.7%), brain atrophy (5.3%), tuberculoma (3.3%), venous thrombosis (2.7%), developmental malformations (2.7%), glioma (1.3%), cavernoma (1.3%), tuberous sclerosis (1.3%), meningioma (0.7%), cerebral abscess (0.7%) and Sturge Weber syndrome (0.7%). Abnormality on MRI was not significantly associated with gender or type of seizure. MR abnormality was observed maximum in patients between 1 to 30 years (30 out of 70 patients i.e. 42.8%) while all the elderly cases showed abnormal MRI, with infract with gliosis being the most common finding. Conclusions : MR imaging should be the first investigation of choice in epileptic syndrome, cerebrovascular disease with seizure, developmental cortical malformations, and vascular malformations.
Krauss G. Epilepsy Is Not Resolved. Epilepsy Curr. 2014;14(6):339–340. Available from: https://dx.doi.org/10.5698/1535-7597-14.6.339.
Panagariya A, Sharma B, Dubey P, Satija V, Rathore M. Preva- lence, Demographic Profile, and Psychological Aspects of Epilepsy in North-Western India: A Community-Based Obser- vational Study. Annals of Neurosciences. 2018;25(4):177–186. Available from: https://dx.doi.org/10.1159/000487072.
Kuzniecky RI. Neuroimaging of epilepsy: Therapeutic implications. NeuroRX. 2005;2(2):384–393. Available from: https://dx.doi.org/10.1602/neurorx.2.2.384.
Fisher RS. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55:475–482. Available from: https://doi.org/10.1111/epi.12550.
Gaillard WD, Chiron C, Cross JH, Harvey AS, Kuzniecky R, Hertz-Pannier L, et al. Guidelines for imaging infants and chil- dren with recent-onset epilepsy. Epilepsia. 2009;50(9):2147– 2153. Available from: https://dx.doi.org/10.1111/j.1528-1167.2009.02075.x.
Jain RS, Khan I, Nagpal K. Identification of structural lesion using a 3-Tesla MRI in partial onset epilepsy with a normal CT scan: A perspective of a tertiary centre in Northern India. Indian J Med Spec. 2018;9(4):187–191. Available from: https://dx.doi.org/10.1016/j.injms.2018.05.008.
Craven IJ, Griffiths PD, Bhattacharyya D, Grunewald RA, Hodgson T, Connolly DJ, et al. Hoggard N. 3.0 T MRI of 2000 consecutive patients with localisation-related epilepsy. Br J Radiol. 1017;85:1236–1278. Available from: https://dx.doi.org/10.1259/bjr/30177037.
Rysz A, Bidziński J, Gołebiewski M, Kroh H, Bonicki W. The value of structural neuroimaging in the selection of patients for epileptic surgery. Neurol Neurochir Pol. 1998;32(2):217–242.
Sheikh NA, Shabnum N, Bhat GA, Kawoosa A, Mushtaq M, Wani MA. Etiological profile of adult onset seizures: a hospital based prospective study from Kashmir, India. Int J Adv Med. 2017;4(3):793–793. Available from: https://dx.doi.org/10.18203/2349-3933.ijam20172274.
Ghosh B, Sengupta S, Bhattacharjee R, Pal S, Saha SP, Ganguly G. Spectrum of peripheral neuropathy in eastern India. J Indian Med Assoc. 2006;104(4):170–163.
Gaillard WD, Weinstein S, Conry J, Pearl PL, Fazilat S, Fazi- lat S, et al. Prognosis of children with partial epilepsy: MRI and serial 18FDG-PET. Neurology. 2007;68(9):655– 659. Available from: https://dx.doi.org/10.1212/01.wnl.0000255942.25101.8d.
Spooner CG, Berkovic SF, Mitchell LA, Wrennall JA, Har- vey AS. New-onset temporal lobe epilepsy in children:
Lesion on MRI predicts poor seizure outcome. Neurology. 2006;67(12):2147–2153. Available from: https://dx.doi.org/10.1212/01.wnl.0000248189.93630.4f.
Gururaj G, Satishchandra P, Amudhan S. Epilepsy in India I: Epidemiology and public health. Ann Indian Acad Neurol. 2015;18(3):263–263. Available from: https://dx.doi.org/10.4103/0972-2327.160093.
Murthy JMK, Narayanan J. New-onset acute symptomatic seizure in a neurological intensive care unit. Neurol India. 2007;55(2):136–136. Available from: https://dx.doi.org/10.4103/0028-3886.32784.
Hauser WA, Annegers JF, Kurland LT. Incidence of Epilepsy and Unprovoked Seizures in Rochester, Minnesota: 1935-1984. Epilepsia. 1993;34(3):453–458. Available from: https://dx.doi.org/10.1111/j.15281157.1993.tb02586.x.
Werhahn KJ. Epilepsy in the Elderly. Dtsch Arztebl Int. 2009;106(9):135–177. Available from: https://dx.doi.org/10.3238/arztebl.2009.0135.
Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C. Epileptic seizures after a first stroke: the Oxfordshire community stroke project. BMJ. 1997;315(7122):1582– 1587. Available from: https://dx.doi.org/10.1136/bmj.315.7122.1582.
Cleary P, Shorvon S, Tallis R. Late-onset seizures as a predictor of subsequent stroke. Lancet. 2004;363(9416):1184– 1186. Available from: https://dx.doi.org/10.1016/s0140-6736(04)15946-1.
Bronen RA. Epilepsy: the role of MR imaging. Am J Roentgenol. 1992;159(6):1165–1174. Available from: https://dx.doi.org/10.2214/ajr.159.6.1442376.
Doescher JS, deGrauw TJ, Musick BS, Dunn DW, Kalnin AJ, Egelhoff JC. Magnetic Resonance Imaging and Electroen- cephalographic Findings in a Cohort of Normal Children With Newly Diagnosed Seizures. J Child Neurol. 2006;21(6):491–495. Available from: https://emedicine.medscape.com/article/1155295overviewLastaccessed.
Colosimo C, Celi G, Settecasi C, Tartaglione T, Rocco CD, Marano P. Magnetic resonance and computerized tomography of posterior cranial fossa tumors in childhood. Di erential diagnosis and assessment of lesion extent. La Radiologia Medica. 1995;90(4):386–95.
Copyright (c) 2020 Author
This work is licensed under a Creative Commons Attribution 4.0 International License.