Value of neuroimaging in epilepsy: An experience from Pakistan

Address for correspondence: Dr. Ahmed Bakhsh Saad Specialist Hospital Prince Faisal Bin Fahd Road, P.O. Box 30353, Al.Khobar 31952 Saudi Arabia ahmedbakhsh@gmail.com

Journal of Neurosciences in Rural Practice

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Abstract

ABSTRACT

Purpose: To detect the possible structural brain lesions in the patients suffering from various kinds of epilepsy during the routine neuroimaging. Materials and Methods: Prospective study of 366 epileptic patients conducted at epilepsy clinic, Rawalpindi-Islamabad Pakistan in an outpatient setting. MRI or CT scan of the brain without contrast was advised in all patients to detect any underlying pathology. Results: A total 21.31% scans were found to be abnormal. Many cases of familial, idiopathic epilepsy and patients without any neurological deficit were found to have structural brain lesions, which might be responsible for their seizures. Conclusion: CT/MRI scan of the brain should be advised in all patients of epilepsy regardless of cause and type of epilepsy. The presence of neurological deficit should not be the sole indication for neuroimaging.

Keywords

Computerized tomography scan

epilepsy

familial

idiopathic

magnetic resonance imaging scan

neurological deficit

partial

surgery

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Conflict of Interest

None declared

References

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[1] Kuzniecky R. I., . Neuroimaging of Epilepsy: Therapeutic Implications. Neuro Rx. 2005;2:384-93.
[Google Scholar]

[2] Barkovich A. J., Berkovic S. F., Cascino G. D., Chiron C, Duncan J. S., Gadian D. G., et al . Guidelines for Neuroimaging evaluation of patients with uncontrolled epilepsy considered for surgery. Epilepsia. 1998;39:1375-6.
[Google Scholar]

[3] Brodie M. J., Shorvon S. D., Canger R, Halász P, Johannessen S, Thompson P, et al . Commission on European Affairs: Appropriate standards of epilepsy care across Europe. ILEA Epilepsia. 1997;38:1245-50.
[Google Scholar]

[4] Radhakrishnan K, . Challenges in the management of epilepsy in resource-poor countries. Nat Rev Neurol. 2009;5:323-30.
[Google Scholar]

[5] Wieshmann U, . Clinical application of neuroimaging in epilepsy. J Neurol Neurosurg Psychiatry. 2003;74:466-70.
[Google Scholar]

[6] Shorvon S. D., . Epidemiology, classification, natural history and genetics of epilepsy. Lancet. 1990;336:93-6.
[Google Scholar]

[7] Abduljabbar M, Ogunniyi A, Daif A. K., Al-Tahan A, Al-Bunyan M, Al-Rajeh S, . Epilepsy classification and factors associated with control in Saudi adult patients. Seizure. 1998;7:501-4.
[Google Scholar]

[8] Thomas S. V., Kutty R, Alexander A, . Management and referral patterns of epilepsy in India. Seizure. 1996;5:303-6.
[Google Scholar]

[9] Wright N. B., . Imaging in epilepsy: A pediatric perspective. Br J Radiol. 2001;74:575-89.
[Google Scholar]

[10] Vernooij M. W., Ikram M. A., Tanghe H. L., Vincent A. J., Hofman A, Krestin G. P., et al . Incidental findings on brain MRI in the general population. N Engl J Med. 2007;357:1821-8.
[Google Scholar]

[11] McCann Dublin A. B., Hill R. P., . The evaluation of seizure disorders by computerized tomography. J Neurosurg. 1979;50:328-32.
[Google Scholar]

[12] Betting L. E., Mory S. B., Lopes-Cendes I, Li L. M., Guerreiro M. M., Guerreiro C. A., et al . MRI reveals structural abnormalities in patients with idiopathic generalized epilepsy. Neurology. 2006;67:848-52.
[Google Scholar]

[13] Duncan J. S., . Brain imaging in idiopathic generalized epilepsies. Epilepsia. 2005;46:108-11. Suppl 9
[Google Scholar]

[14] Woermann F. G., Sisodiya S. M., Free S. L., Duncan J. S., . Quantitative MRI in patients with idiopathic generalized epilepsy, Evidence of widespread cerebral structural changes. Brain. 1998;121:1661-7.
[Google Scholar]

[15] Wyllie E, Chee M, Granström M. L., DelGiudice E, Estes M, Comair Y, et al . Temporal lobe epilepsy in early childhood. Epilepsia. 1993;34:859-68.
[Google Scholar]

[16] Morris H. H., Estes M. L., Gilmore R, Van Ness P. C., Barnett G. H., Turnbull J, . Chronic intractable epilepsy as the only symptom of primary brain tumor. Epilepsia. 1993;34:1038-43.
[Google Scholar]

[17] Swartz B. E., Tomiyasu U, Delgado-Escueta A. V., Mandelkern M, Khonsari A, . Neuroimaging in temporal lobe epilepsy: Test sensitivity and relationships to pathology and postoperative outcome. Epilepsia.. 1992;33(4):624-34.
[Google Scholar]