Computed tomography in the assessment of seizure-induced supratentorial neuron loss

Epilepsy patients develop atrophy of the hippocampus and the cerebellum. Because reports exist, in which diffuse atrophy of the CNS of epilepsy patients is mentioned, we wanted to investigate if computed tomography (CT) can demonstrate a decrease of the cerebral volume correlated with the length of time during which the patients have had seizures. We measured the bifrontal ratio, the bicaudate ratio, the lateral ventricular brain ratio, and the sylvian fissure ratio of the CT images of 124 neurologically intact patients with a duration of epilepsy from 3 months to 39 years. Multiple regression analysis revealed no correlation between the CT indices and the seizure types or the time elapsed from the first seizure to CT. The well-known decrease of the CT measures with advancing age was confirmed: among the women by all four measurements; the men only exhibited significant increases of the sylvian fissure and the bicaudate ratios. If diffuse cerebral atrophy occurs as a complication of epilepsy, it does not reach a degree, which allows it to be visualized by CT.