Computed tomographic brain scan findings in Saudi epileptic patients

Computed tomographic (CT) brain scan was performed on 142 consecutive epileptic patients of Saudi Arab extraction without clinical features of acute illness or a progressive neurological disorder at presentation. CT brain scan was normal in 56 patients (39%). CT scan was abnormal in 57 (73%) of 78 patients over 20 years of age compared with 29 (45%) of 64 younger patients (x2 = 11.3; p < 0.001); and in 25 (75%) of 36 patients presumed to suffer from symptomatic epilepsy on clinical grounds compared with 36 (46%) of 76 others with idiopathic epilepsy (x2 = 8.2; p < 0.01). Potentially treatable lesions were detected in 11 (8%) patients and congenital lesions in 9 (6%). Multiple lesions were present in the CT scan of 20 patients. Cerebral atrophy (CA), the commonest lesion detected, was present in 52 (37%) of 142 patients and 60% of 86 patients with abnormal CT scans. Diffuse CA was present in 21% of 78 patients over 20 years of age compared with 14% of 64 younger patients. Similarly, diffuse CA occurred in 25% of 48 patients with late-onset epilepsy compared with 14% of 94 patients in whom seizures began before the age of 20 years. Our findings are in accord with those previously reported and underscore the need for selective and judicious use of CT scan facilities in epileptic patients.