Related Experiment Video
Updated: Jun 1, 2026
A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
Published on: November 13, 2016
The appropriate neuroimaging study in persons with epilepsy
Warinthorn Phuttharak1, Kittisak Sawanyawisuth, Angkana Kawiwungsanon
1Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Insights
Computed tomography (CT) scans are more effective than magnetic resonance imaging (MRI) for detecting brain abnormalities in persons with epilepsy (PWE) in resource-limited settings. CT is superior for identifying stroke and cysticercosis, while MRI excels in diagnosing hippocampal sclerosis.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Epilepsy diagnosis often relies on neuroimaging.
- Resource limitations in some facilities necessitate careful selection of imaging modalities.
- Computed tomography (CT) and magnetic resonance imaging (MRI) are common brain imaging techniques.
Purpose of the Study:
- To compare the effectiveness of CT and MRI in detecting neuroimaging abnormalities in persons with epilepsy (PWE).
- To guide the appropriate selection of neuroimaging techniques for PWE in resource-limited settings.
Main Methods:
- Retrospective analysis of 180 persons with epilepsy (PWE) aged over 15 years who underwent brain CT or MRI.
- Comparison of abnormal findings detected by CT and MRI.
- Statistical analysis to determine the superiority of one modality over the other for specific conditions.
Main Results:
- CT scans detected significantly more brain abnormalities in PWE compared to MRI (P = 0.0131).
- CT was superior in identifying stroke and cysticercosis.
- MRI demonstrated higher sensitivity in diagnosing hippocampal sclerosis.
Conclusions:
- CT is a more effective initial neuroimaging choice for PWE in resource-limited facilities due to its higher detection rate of general brain abnormalities.
- MRI should be reserved for specific indications like suspected hippocampal sclerosis, considering cost and availability.
- Clinicians need to judiciously select imaging modalities based on resource availability and clinical suspicion.
Abstract:
This article presents the appropriate neuroimaging for persons with epilepsy (PWE) in resource-limited facilities. PWE from the Epilepsy Clinic, Srinagarind Hospital between November 1, 2003 and January 30, 2005 were enrolled. The inclusion criteria were PWE aged more than 15 years who underwent computed tomography (CT) or magnetic resonance imaging (MRI) of the brain. We compared the abnormal neuroimaging findings by both imaging modalities. A total of 180 out of 370 PWE met the inclusion criteria, comprising 101 men (56.1%) and 79 women (43.9%). There were 75 PWE who underwent only CT imagings, 85 PWE who underwent only MRI and 20 PWE who underwent both CT and MRI studies. CT scan significantly detected brain abnormalities more than MRI in PWE (P = 0.0131). It was also found that CT scan was superior than MRI in detecting stroke and cysticercosis in PWE, whereas MRI was significantly better in the diagnosis of hippocampal sclerosis. Clinicians should be able to choose appropriate brain imaging for PWE, particularly in resource-limited countries. MRI should be preserved for particular brain lesion owing to availability and cost effectiveness.
