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Is routine computerised axial tomography in epilepsy worth while?

A C Young, J B Costanzi, P D Mohr

    Lancet (London, England)
    |December 25, 1982
    PubMed
    Summary
    This summary is machine-generated.

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    Routine brain CT scans offer limited value for epilepsy management. CT is most useful for patients with focal seizures and specific EEG findings, while clinical assessment remains crucial.

    Area of Science:

    • Neurology
    • Radiology
    • Epilepsy Management

    Background:

    • Epilepsy is a neurological disorder characterized by recurrent seizures.
    • Computerised axial tomography (CT) scanning is a neuroimaging technique used to visualize the brain.
    • The utility of routine CT scanning in epilepsy evaluation is debated.

    Purpose of the Study:

    • To assess the diagnostic value of routine brain CT scans in patients with epilepsy or isolated seizures.
    • To determine the impact of CT findings on patient management and treatment decisions.

    Main Methods:

    • A prospective study of 220 consecutive patients diagnosed with epilepsy or isolated seizures.
    • Evaluation of CT scan findings in relation to seizure type, clinical signs, and electroencephalogram (EEG) results.

    Related Experiment Videos

  • Analysis of how CT results influenced surgical treatment decisions and overall patient management.

    • Main Results:

    • Abnormal CT scans were identified in over 50% of patients with focal seizures accompanied by focal signs or EEG delta focus.
    • In patients lacking focal features, 94% had normal CT scans.
    • Only 25% of CT abnormalities were surgically treatable, and CT altered management in only 10% of all patients.
    • Three cases of tumors were initially missed by CT scanning.

    Conclusions:

    • Routine CT scanning has limited value in the general epilepsy population.
    • CT is most beneficial for patients presenting with focal seizures and specific EEG abnormalities.
    • Clinical assessment and EEG remain the cornerstone of epilepsy diagnosis and management, with CT reserved for select cases.