J of IMAB. 2012; 18(3):353-356
USE OF STRUCTURAL MRI IN PATIENTS WITH MEDICALLY REFRACTORY SEIZURES
Ara G. Kaprelyan¹, Dimitar M. Minchev¹, Alexandra J. Tzoukeva¹, Margarita V. Grudkova¹, Radoslav Georgiev²,
1) Department of Neurology 2) Department of Radiology;
Medical University "Prof. P. Stoyanov", Varna, Bulgaria.

ABSTRACT:
Introduction: Refractory epilepsy is common in patients with structural brain lesions including acquired disorders and genetic abnormalities. Recently, MRI is a precise diagnostic tool for recognition of different structural causes underlying medically intractable seizures.
Objective: To evaluate the usefulness of MRI for detection of brain lesions associated with refractory epilepsy.
Material and methods: 49 patients (20M and 29F; aged 48.6±24.7 years) with refractory epilepsy were included in the study. They presented with partial (46.0%), secondary (31.0%) or primary (23.0%) generalized tonic-clonic seizures. Clinical diagnosis was based on the revised criteria of ILAE. Structural neuroimaging (MRI), EEG recording, and neurological examination were performed.
Results: MRI detected different structural brain abnormalities totally in 36 (73.5%) patients, including cerebral tumors (21p), cerebrovascular accidents (5p), hyppocampal sclerosis (3p), developmental malformations (2p), postencephalitic lesions (2p), arachnoid cysts (2p), and tuberous sclerosis (1p). Neuroimaging revealed normal findings in 13 (27.5%) cases. EEG recordings showed focal epileptic activity in 38 (77.6%) patients, including 33 cases with and 5 without structural brain abnormalities.
Conclusion: This study revealed that structural brain lesions are commonly associated with refractory epilepsy. We suggested that MRI is a useful diagnostic method for assessment of patients with uncontrolled seizures or altered epileptic pattern.

Key words: structural MRI, refractory seizures, brain lesions.

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Please cite this article as: Kaprelyan AG, Minchev DM, Tzoukeva AJ, Grudkova MV, Georgiev R. USE OF STRUCTURAL MRI IN PATIENTS WITH MEDICALLY REFRACTORY SEIZURES. J of IMAB. 2012; 18(3):353-356. DOI: 10.5272/jimab.2012183.353;

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