Computed Tomography Findings in Patients with Seizure Disorder

Abstract

Introduction: Seizure occurs in up to 10% of the population, whereas epilepsy is a chronic disease characterized by recurrent seizures that may affect up to 2% of the population. Modern neuroimaging is useful in diagnosis of abnormalities underlying the epilepsies, but the information provided by imaging techniques can also contribute to proper classification of certain epileptic disorders and can delineate the genetics of some underlying syndromes. Neuroimaging is even more important for those patients who have medically intractable seizures. This study was carried out to establish different etiologies of seizures, to correlate the clinical data and radiological findings in cases of seizure, and to identify the common etiologies in different types of seizures.
 
 Methods: This was a retrospective hospital-based study conducted in the Department of Radiodiagnosis of Lumbini Medical College Teaching Hospital. Records of patients of past two years, admitted in any department of the hospital with history of seizure disorder and underwent a Computed Tomography (CT) of brain were included. The CT patterns were assessed and the data were tabulated and statistically analyzed.
 
 Results: There were a total of 480 cases out of which 263 (55%) were male and 217 (45%) were female with M:F ratio of 1.2:1. Generalized seizure was more frequent than partial seizure in both gender. In 274 cases of generalized seizures, CT scan findings were abnormal in 151 cases and normal finding observed in 123 cases. In 206 cases of partial seizures, 125 cases were abnormal and 81 having normal CT scan findings. Age wise distribution showed highest number (n=218) of cases in young group (<20 yr) and least number (n=45) in eldest group (>60 yr). The most common cause of seizure was calcified granuloma (n=79, 16.5%) followed by neurocysticercosis (NCC, n=64, 13%). Diffuse cerebral edema, sub-arachnoid hemorrhage, and hydrocephalus was seen only in lower age group particularly among 1-20 years. Infarct and diffuse cortical atrophy were most common cause of seizure in older age group. NCC and tuberculoma are the most common cause of partial seizure whereas cerebral infarcts, hemorrhage, malignancy, diffuse cortical atrophy are the most common cause of complex seizure. Few rare diseases like Fahr disease and tuberous sclerosis were also found in CT scan of seizure patients.
 
 Conclusion: NCC and tuberculoma are the most common cause of partial seizure whereas cerebral infarcts, hemorrhage, malignancy, and diffuse cortical atrophy are the most common cause of complex seizure. CT scan plays an important role as a preliminary tool in radiological assessment of patients presenting with seizures.