The Evaluation of Seizure Disorders by Computerized Tomography

McGahan, John P.; Dublin, Arthur B.; Hill, Rick; Burke, Dennis P.

doi:10.1097/00004728-198002000-00037

Cited by 7 publications

(12 citation statements)

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“…The high occurrence of focal CT abnormalities in our patient population (45.8%), which agrees with previous reports (Gastaut et al, 1976;ScolloLavizzari et al, 1977;J a m and Masuhr, 1978;McGahan et al, 1979;Jabari et al, 1980), confirms the usefulness of CT in identifying an underlying cause in patients with epileptic seizures. In past reports, when the diagnosis was based on the clinical picture, EEG, radionuclide scan, and invasive neuroradiological procedures, such as angiography and pneumoencephalography, the reported occurrence was not greater than 30% (Juul-Jensen, 1965;Gudmundsson, 1966).…”

Section: Discussionsupporting

confidence: 93%

“…The increasing number of CT abnormalities with increasing age is in agreement with previous reports (McGahan et al, 1979). As expected, focal CT lesions were discovered more frequently in the group of patients with partial seizures (Bogdanoff et al, 1975;Loiseau et al, 1977).…”

Section: Discussionsupporting

confidence: 91%

“…Since its introduction, computed tomography (CT) has almost entirely replaced previously used neuroradiological methods and has become indispensable in the evaluation of patients with epilepsy (Gastaut et al, 1976;Scollo-Lavizzari et al, 1977; Janz and Masuhr, 1978; McGahan et al, 1979). With CT, the number of patients found to have seizure causing abnormalities has increased, and more information on the pathology of the lesions has resulted.…”

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confidence: 99%

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Computed Tomography in Adult‐Onset Epileptic Seizures in a City Hospital Population

Daras

1987

Epilepsia

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Computed tomography (CT) was performed on 155 patients from a city hospital population who developed seizures after age 20. CT was normal in 58 (37.4%) and abnormal in 97 patients (62.6%). A focal abnormality was seen in 71 patients (45.8%). Lesions potentially correctable by surgery were found in 24 patients (15.4%). As expected, the occurrence of abnormal CTs was higher (73%) in patients with partial seizures. Although CT is undeniably useful in evaluating the cause of seizures, no demonstrable lesion was found in a relatively large number of patients (37.4%).

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

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confidence: 99%

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Computed Tomography in Adult‐Onset Epileptic Seizures in a City Hospital Population

Daras

1987

Epilepsia

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“…3 The abnormalities reported were tumours, trauma, infarcts, cerebral atophy, hydrocephalus, porencephaly and vascular abnormalities.…”

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confidence: 99%

Appearing and disappearing CT scan abnormalities in epilepsy in India--an enigma.

Bansal

Dua

Gupta

et al. 1989

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY In 230consecutivecases ofepilepsy, CT abnormalities were found in 5[7%. Out ofthese, 91 cases (39-5%) had non specific abnormalities consisting mostly of ring lesions, hyperdense disc lesions with surrounding oedema in enhanced scans and in a small percentage hypodense lesions, generalised brain oedema and calcifications. All these cases were treated with anticonvulsant drugs alone. A follow up scan was possible in 31 cases, 12 weeks or later, after the control of the seizures. Out of these 31 cases, 24 showed a complete or significant resolution and five remained unchanged. Two of these cases showed an increase in the lesions which resolved on treatment with antituberculous drugs. These lesions therefore may have an aetiology other than tuberculosis in the majority of cases and there is ample justification in treating them initially with anticonvulsant drugs only.CT abnormalities in cases of epilepsy have been variously reported between 36 and 56%,' 10,2 and 60%.3 The abnormalities reported were tumours, trauma, infarcts, cerebral atophy, hydrocephalus, porencephaly and vascular abnormalities.Unusual CT abnormalities have been reported from India in various series consisting of ring and high attenuation disc lesions with surrounding oedema.4These cases have been labelled as intracranial tuberculomas.4s The diagnosis was achieved through biopsy in a few cases but largely through the disappearance of these features in response to therapy with antituberculous drugs or circumstantial evidence on finding tubercolous lesions elsewhere in the body. It was later noticed that these lesions disappeared in some cases merely on treatment with anticonvulsants and without any antituberculous drugs.6 A contradicatory report7 has come from India which again stressed the possibility of these lesions being tuberculomas. We report our experience of CT abnormalities in 230 consecutive patients with epilepsy who were willing to have a CT scan done in addition to other investigations. Materials and methodsThe study included 230 consecutive patients with epilepsy, focal and generalised, who attended the neurology clinic of the Medical College and Hospital, Rohtak, India, and who were willing to have a CT scan. Patients with syncope, hysterical seizures, blackouts of indeterminate nature, brain tumours, and exposure to intoxicants were excluded. Routine blood counts, ESR, urine, blood biochemistry-blood sugar, urea, chest and skull radiographs, EEG and cerebrospinal fluid (CSF) examinations were carried out in each case. CT was carried out within six weeks of an ictus and the majority were enhanced. CT was repeated after 12 weeks or more of anticonvulsant therapy wherever possible. Observations and ResultsA total of 230 cases were studied. Sixty three had focal and 167 generalised seizures. The age varied between five to 54 years (mean 23 58) and the male to female ratio was 2:1. Todd's palsy was seen in seven cases of focal epilepsy. The CT scan was abnormal in 119 (51-8%) cases. Twenty eight patients had a specific CT abnor...

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“…It should be noted that previous reports of its association with epilepsy have usually failed to include control data. [26][27][28][29] CT scanning is at present the best widely available non-invasive method of detecting discrete cerebral vascular lesions which may often, as we have shown, be clinically unsuspected. Nevertheless, a number of patients with cerebral vascular disease (as demonstrated by cerebral angiography for instance) have a normal Cf scan, and the proportion of patients with ischaemic lesions in this study should be considered a minimum estimate of those with cerebral vascular disease.…”

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confidence: 99%

Evidence of vascular disease from CT scanning in late onset epilepsy.

Shorvon¹,

Gilliatt²,

Cox³

et al. 1984

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY The CT scans of 74 patients presenting with late-onset epilepsy not due to cerebral tumour were compared with those of an age and sex-matched control group for evidence of cerebral vascular disease. Changes in the scan indicative of cerebral atrophy (enlarged ventricles and cortical sulci) were seen in similar numbers in both patients and controls. However, the scans revealed a highly significant excess of ischaemic lesions in the epileptic patients, in the form of discrete areas of infarction and low attenuation of the periventricular white matter. These changes, which were only seen in two of the controls, were present in 13 of the epileptic patients. The median age at the onset of epilepsy in the 13 patients with ischaemic lesions was 62 years, and they showed an increased incidence of systemic vascular disease and of abnormal neurological signs. In six of the 13 cases, however, clinical examination was normal and CT scanning provided the only evidence of underlying vascular disease.

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The Evaluation of Seizure Disorders by Computerized Tomography

Cited by 7 publications

References 0 publications

Computed Tomography in Adult‐Onset Epileptic Seizures in a City Hospital Population

Computed Tomography in Adult‐Onset Epileptic Seizures in a City Hospital Population

Appearing and disappearing CT scan abnormalities in epilepsy in India--an enigma.

Evidence of vascular disease from CT scanning in late onset epilepsy.

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