CT-Ergebnisse bei Patienten mit Epilepsie. Eine prospektive Studie

Abstract

CT was performed in more than 500 patients with epilepsy. We did not single out any patient group; in about half of the patients seizures are the only symptom, in the remaining group one symptom among others. CT findings allow very clear distinction between different patient groups. The first group contains patients with symptomatic epilepsy and well-defined CT diagnosis like tumors, a.v. angiomas, tuberous sclerosis, etc. A second patient group consists of patients with seizures only which proved to be symptomatic cases too. In the largest group of about 50%, CT was normal; this contained genuine epilepsy and cases of suspected perinatal brain damage, but also cases with later onset epilepsy. Besides cortical atrophy and cystic changes, the most frequent findings in generalized, psychomotoric, and focal seizures were areas of low density without any enhancement effect after i.v. application of a contrast medium. We are quite sure that this collective is inhomogenous too in spite of its uniform CT. The most valid means of discriminating between several pathogenetic conditions will be CT controls and the further clinical course; etiology still remains unknown in most cases. If we could exclude the cases of perinatal brain damage, trauma, postinfectious states, and cerebral ischemia it would be possible to separate a group of patients on which we could concentrate our efforts on the differential diagnosis between gliomas of slow growth, gliosis, or other nontumorous cerebral conditions. The studies will be continued.