Chronic Epilepsy Does Not Cause Measurable Structural Changes on MRI.

Abstract

The Structural Consequences of Newly Diagnosed Seizures Liu RSN, Lemieux L, Bell GS, Sisodiya SM, Bartlett PA, Shorvon SD, Sander JWAS, Duncan JS Ann Neurol 2002;52:573–580 Intractable epilepsy may be associated with widespread structural cerebral damage. We determined whether structural damage occurs to the hippocampus, cerebellum, and neocortex in the first few years after a diagnosis of seizures. Sixty-eight patients older than 14 years with newly diagnosed seizures and 90 matched controls underwent serial magnetic resonance imaging (MRI) brain scans 3.5 years apart. Using quantitative analysis of serial scans, we determined changes in hippocampal volume, hippocampal T2 relaxometry, and total and regional brain volumes. Thirty-four (50%) patients had recurrent unprovoked seizures between baseline and follow-up scans. One patient with preexisting hippocampal sclerosis (HS) did not develop progressive hippocampal damage. Group analyses found no difference in change in cerebral measures between patients and controls or between patients with and without recurrent seizures. Significant quantitative changes in individuals were largely attributable to preexisting cerebral lesions or alcohol abuse. Subtle changes detected in individuals over a 3.5-year period but were not related to a history of overt seizures. Our results show patients with newly diagnosed seizures are not generally at increased risk of seizure-induced structural cerebral damage as detected with MRI. Cerebral damage may occur before the onset of seizures or develop insidiously over a more prolonged period