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We studied 59 seizure patients with CT,MR,and EEG to determine the efficacy of each in the detection of an epileptogenic focus.EEG was most sensitive(67%).MR was next(53%),and CT was least sensitive(42%).MR detected an abnormality in five patients(8%)in whom CT was negative.EEG was positive in each of these patients.CT failed to demonstrate any focal lesion not detected by MR.MR and CT detected focal abnormalities in seven patients(12%)who had negative EEGs.Five of the seven patients had brain tumors.Eighteen of the 26 patients who underwent surgery had positive CT and MR;14 of these patients had tumors.The remaining eight patients who had surgery all had temporal lobectomies for intractable seizures;none had tumors.In the complex partial seizure subgroup of 34 patients,MR was positive in 44%,CT was positive in 29%,and EEG was positive in 80%.We consider MR to be the imaging procedure of choice for the detection of an epileptogenic focus in seizure patients.When indicated,CT may be performed as a second procedure to try to distinguish neoplasm from thrombosed vascular malformations and other lesions. |
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CAT scan
CAT scan,abnormal
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electroencephalogram,abnormalities of
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seizure,psychomotor-temporal lobe
seizure,surgical treatment of
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temporal lobectomy
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