Magnetic resonance imaging and complex partial seizures

Magnetic resonance imaging (MRI) is a new imaging modality with potential usefulness in the evaluation of patients with seizure disorders. We studied 100 consecutive patients with complex partial seizures comparing computerized cranial tomography (CCT) with MRI. Our study revealed 36 patients with CCT abnormalities. Of these, 30 (83%) had focal abnormalities. MRI demonstrated 45 patients with abnormalities, 34 (76%) were focal. Intracranial calcifications were not visualized by MRI, but were easily demonstrated by CCT. MRI was more sensitive in visualizing cerebral atrophy, abnormal cerebral vasculature, and lesions in the posterior fossa and suprasellar region. Most importantly, several patients who had normal CCTs had abnormal MRIs consistent with neoplastic lesions. As MRI becomes more available, this imaging modality along with EEG, should be the studies of choice in evaluating patients with partial epilepsy.