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Magnetic resonance imaging of intractable complex partial seizures: pathologic and electroencephalographic
C F Dowd1, W P Dillon, N M Barbaro
1Department of Radiology, University of California San Francisco Medical Center 94143-0628.
Epilepsia
|July 1, 1991
Summary
Magnetic resonance imaging (MRI) can identify seizure foci in patients with complex partial seizures (CPS). Specific MRI sequences improve detection of abnormalities, aiding surgical planning for refractory epilepsy.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Complex partial seizures (CPS) present diagnostic challenges.
- Previous studies show variable utility of MRI in CPS evaluation.
Purpose of the Study:
- To assess MRI accuracy in identifying seizure foci in medically refractory CPS.
- To correlate MRI findings with surgical pathology and electroencephalography (EEG) data.
Main Methods:
- Retrospective analysis of 20 patients with medically refractory CPS.
- Correlation of MRI findings with surgical pathology and EEG localization.
- Evaluation of specific MRI sequences for artifact reduction.
Main Results:
- MRI identified abnormalities in all 20 patients.
- Mesial temporal sclerosis (MTS) was present in 11 patients, with 64% showing MRI abnormalities.
- Other structural abnormalities included tumors, vascular malformations, and developmental defects.
Conclusions:
- MRI is valuable for evaluating patients with medically refractory CPS.
- Specific MRI sequences, like coronal long TR/dual echo with artifact reduction, enhance diagnostic yield.
- No patient had normal MRI, underscoring its utility in identifying the epileptogenic zone.