Identification of structural lesion using a 3-Tesla MRI in partial onset epilepsy with a normal CT scan: A perspective of a tertiary centre in Northern India

Abstract

Abstract Background The aim of this study is to investigate the utility of 3-Tesla MRI in cases of partial onset epilepsy with a previous normal CT scan. We confer the results of MRI findings in 50 cases of partial onset epilepsy from 2014–16 using 3-Tesla MRI. Materials and methods Study was conducted on 50 patients of partial onset epilepsy from April 2014 to March 2016 from a tertiary health centre in Rajasthan, India using 3-Tesla Philips Ingenia scanner. All patients of partial epilepsy having a normal CT scan were included and underwent MRI brain with epilepsy protocol. Patients with isolated generalized, myoclonic or absence seizure types were excluded. Those having inflammatory or granulomatous lesions on MRI were excluded from the analysis. Results There were a total of 50 patients (28 males), mean age of onset was 20.21 years, ranging from 7 to 50 years; commonest presentation was that of focal seizures combined with multiple seizure types (60%). Out of these patients, MRI could localize a structural lesion in 64% cases who were having no corresponding abnormalities on a CT scan with a sensitivity of 86.7% and specificity of 73.5%. The detected abnormalities were Mesial temporal sclerosis in 30% (n = 15), Vascular malformation 10% (n = 5), Cortical malformation 8% (n = 4), Encephalitis 8% (n = 4), Neurodegenerative 4% (n = 8), cerebritis 2% (n = 1) and paraganglioma 2% (1). Conclusion In evaluation of structural lesions in cases of partial onset epilepsy, 3-Tesla MRI should be a prerequisite. Detection of focal structural lesion may help in planning epilepsy surgery for some of these candidates in future.