What is the role of imaging in the diagnosis of first adult seizure?

Updated: Nov 30, 2017
  • Author: Eissa Ibrahim AlEissa, MD, MBBS; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Magnetic resonance imaging (MRI) improves diagnostic accuracy. Using clinical and electroencephalographic (EEG) data alone, King et al were able to identify 23% of patients as having primary generalized epilepsy, 54% as having partial epilepsy, and 23% as having unclassified seizures. [28] Using clinical, EEG, and MRI data, the investigators were able to determine that 23% of patients had primary generalized epilepsy, 58% had partial epilepsy, and 19% had unclassified seizures. [28]

Computed tomography (CT) scanning may miss surgically remedial brain lesions that would otherwise be detected by MRI. King et al found that CT scanning detected only 12 of the 28 brain lesions that were detected by MRI; 7 of the missed lesions were brain tumors. [28]

Neuroimaging is unlikely to detect brain lesions in patients with clinical and EEG features of idiopathic generalized epilepsy or benign rolandic epilepsy. King et al found that MRI did not detect any brain lesions in 49 patients with clinical and EEG features of idiopathic generalized epilepsy or in 11 patients with benign rolandic epilepsy. [28]


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