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Disappearing CT lesions in epilepsy.

R K Goulatia1, A Verma, N K Mishra

  • 1Department of Neurology and Neuroradiology, All India Institute of Medical Sciences, New Delhi.

Epilepsia
|September 1, 1987
PubMed
Summary

Seizures can cause temporary, reversible lesions on computed tomography (CT) scans in epileptic patients. These CT abnormalities, likely cerebral edema, resolve when seizure activity stops, preventing misdiagnosis.

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Epilepsy is a neurological disorder characterized by recurrent seizures.
  • Computed tomography (CT) is a crucial diagnostic imaging tool in neurology.
  • Distinguishing seizure-related imaging findings from other pathologies is clinically important.

Purpose of the Study:

  • To report and characterize reversible CT lesions associated with epileptic seizure activity.
  • To investigate the relationship between seizure discharge and radiological findings.
  • To differentiate seizure-induced CT abnormalities from tumors, infarction, or tuberculomas.

Main Methods:

  • Retrospective analysis of CT scans from 46 epileptic patients.
  • Correlation of radiological findings with seizure activity and electroencephalography (EEG) data.
  • Exclusion of infectious and neoplastic etiologies (tuberculosis, cysticercosis).

Main Results:

  • A series of reversible CT lesions were observed in epileptic patients treated solely with antiepileptic drugs.
  • Maximal radiological changes corresponded to areas of maximal epileptic discharge.
  • Lesions recurred with seizure recurrence and resolved upon seizure arrest, suggesting a functional, edema-related cause.

Conclusions:

  • Epileptic seizures can induce CT-demonstrable focal brain abnormalities, likely due to transient cerebral edema from altered vascular permeability.
  • Recognition of this entity is vital to avoid misdiagnosis of serious intracranial pathologies in patients with seizure disorders.
  • This finding highlights a potential imaging correlate of acute seizure activity.

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