Prevalence and Patterns of MRI Abnormalities in Seizure Patients at a Tertiary Care Center: A Cross-Sectional Study

Abstract

Introduction: Seizure is one of the most common neurological disorders, having multiple etiological factors. It has always been a challenging problem to identify the causes of seizures. MR (Magnetic Resonance) imaging is one of the important tools in the evaluation of patients with seizures. The objective of our study was to identify the common structural MR abnormalities in seizure patients and to study the prevalence of structural MR abnormalities according to age and sex.
Methods: This cross-sectional descriptive study of 109 patients with clinical impressions of seizure from various inpatient and outpatient departments of Tribhuvan University Teaching Hospital, Institute of Medicine (TUTH/IOM) over 11 months was conducted. Imaging protocols included T1/T2/ FLAIR/ DWI-ADC axial, T1 sagittal, T2 coronal, T1 sagittal, FLAIR, T1 IR coronal oblique, T2* axial. Specially designed sequences such as T1W IR oblique coronal, SE FLAIR oblique coronal, and T2* GRE sequences were used.
Results: A total of 109 seizure patients, ranging in age from 7 months to 89 years, underwent MRI brain imaging. Epileptogenic MR abnormalities were observed in 50.5% of the patients, while no such abnormalities were found in 49.5% of the patients. Common structural abnormalities included infarcts, gliosis, and encephalomalacia changes (15.6%), sequelae of previous insults (8.2%), neurocysticercosis (7.3%), neoplasms (5.5%), developmental malformations (3.6%), mesial temporal sclerosis (2.7%), tuberous sclerosis (0.9%), hypothalamic hamartoma (0.9%), and others.
Conclusions: The spectrum of MR abnormalities in seizure patients includes infarcts and gliosis, cerebral infections, neoplasms, developmental malformations, and mesial temporal sclerosis.