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Updated: Feb 14, 2026

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Neuroimaging of first-ever seizure: Contribution of MRI if CT is normal
Kevin Ho1, Nicholas Lawn1, Michael Bynevelt1
1Radiology Department (KH), Fremantle Hospital; Department of Neurology (NL, JL, JD), Royal Perth Hospital; and Radiology Department (MB), Sir Charles Gairdner Hospital, Perth, Western Australia.
Abstract:
The role of neuroimaging in the assessment of a first-ever seizure has not been well-defined, in particular the utility of MRI when CT is normal. The results of neuroimaging (CT brain, MRI brain, or both) in 1,013 adults with first-ever unprovoked seizure were correlated with clinical features and seizure outcome. Epileptogenic lesions were identified in 29%. Of patients with a normal CT who also had MRI, 12% had an epileptogenic lesion on MRI, the strongest independent predictor of which was a focal abnormality on EEG. Patients with an epileptogenic lesion had a higher risk of seizure recurrence, including when this was only evident on MRI.
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