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Neuroimaging in refractory partial seizures: comparison of PET, CT, and MRI

W H Theodore, R Dorwart, M Holmes

    Neurology
    |June 1, 1986
    PubMed

    Insights

    Magnetic resonance imaging (MRI) is more sensitive than computed tomography (CT) for detecting structural abnormalities in patients with partial seizures, especially when underlying positron emission tomography (PET) hypometabolism is present.

    Area of Science:

    • Neurology
    • Radiology
    • Nuclear Medicine

    Background:

    • Partial seizures are a common form of epilepsy.
    • Accurate diagnosis relies on identifying underlying structural or metabolic abnormalities.
    • Advanced neuroimaging techniques like CT, MRI, and PET are crucial for diagnosis.

    Purpose of the Study:

    • To compare the diagnostic sensitivity of x-ray computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) in patients with partial seizures.
    • To evaluate the utility of these imaging modalities in detecting structural lesions associated with epileptic activity.

    Main Methods:

    • A comparative study involving 36 patients diagnosed with partial seizures.
    • Utilized x-ray CT, MRI, and 18F-2-deoxyglucose PET scans.
    • Correlated imaging findings with electroencephalogram (EEG) results, categorizing patients into localized and nonlocalizing discharge groups.

    Main Results:

    • MRI detected abnormalities in 9 out of 17 patients with localized EEG discharges and 11 out of 19 with nonlocalizing discharges.
    • CT identified abnormalities in 4 of 14 patients with localized discharges and 10 of 12 with nonlocalizing discharges.
    • PET revealed abnormalities in 13 of 14 patients with localized discharges and 8 of 12 with nonlocalizing discharges. MRI demonstrated higher sensitivity than CT in identifying structural lesions linked to PET-identified hypometabolism.

    Conclusions:

    • MRI is superior to CT in detecting structural lesions in patients with partial seizures.
    • Neuroimaging, particularly MRI, plays a vital role in the etiological diagnosis of epilepsy.
    • Combined use of advanced imaging techniques may improve diagnostic yield in complex epilepsy cases.

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