Structural Brain Lesions in Epilepsy Patients: An Experience from Northeast India

Abstract

Objectives The aim of this article is to study the various structural causes and role of magnetic resonance imaging (MRI) in epilepsy patients. Materials and Methods A 4-year retrospective cross-sectional study was conducted in Northeast India. The MRI brain findings of epilepsy patient were collected and analyzed for the years 2017 to 2020. Result A total of 630 patients of epilepsy underwent MRI brain with normal findings noted in 280 patients (44.4%). The other groups of 350 epilepsy patients (55.5%) had abnormal MRI brain findings and were included in the study with a minimum age of 2-month old and a maximum of 80 years. The most common abnormal MRI finding belongs to the infectious group (33.7%), with neurocysticercosis being the most common infectious etiology (p-value < 0.001). Gliosis was seen in 57 patients (16.3%), mostly in the middle-aged group. Vascular etiology was seen in 44 patients (12.6%), mostly in the middle-aged group. Features of hypoxic brain injury was seen in 26 patients (7.4%), mostly among patients of <18 years age. Mesial temporal lobe epilepsy was seen in 45 patients (12.9%), mostly seen in the adolescent. Neuronal migration defect was seen in 23 patients (6.5%), mostly among adolescent and young adults. Other abnormal MRI findings were tumor in 8 patients (2.3%), diffuse gyral swelling in 11 patients (3.1%), Rasmussen encephalitis in 4 patients (1.1%), neurocutaneous syndrome in 4 patients (1.1%), radiation necrosis and cyst in 1 patient each, Dyke-Davidoff-Masson syndrome in 3 patients, moyamoya disease in 1 patient, posterior reversible encephalopathy syndrome in 2 patients, and vasculitis in 4 patients. Conclusion MRI brain is the key investigation to identify the epileptic focus in epilepsy patients helping in their further treatment and prognosis.