The role of neuroimaging in the investigation of patients with single seizures, febrile seizures, or refractory partial seizures
Leonardo Bonilha, Maria Augusta Montenegro, Fernando Cendes, Li M. Li
Med Sci Monit 2004; 10(3): RA40-46
Seizures are a symptom of an underlying brain disorder. The accurate identification of the nature of the disease generating the seizures facilitates treatment and can prevent further brain damage. The understanding of the physiopathology underlying the seizures has been greatly enhanced by the possibility to examine these patients with advanced forms of neuroimaging. Among different forms of investigation, neuroimaging techniques play a major role in diagnosis and decision-making in the care of patients with epilepsy. We review the contributions of current methods of imaging in the investigation of patients with single seizures, febrile seizures or refractory seizures, assessing the practical aspects, benefits, and operational costs of various neuroimaging techniques. The focus is on MRI, which is the imaging modality of choice for outpatient investigation. We also assessed the benefits from CT scans, which remain the first option for emergency seizure assessment. The aim was to evaluate how the structural, functional and metabolic information provided by modern techniques of neuroimaging decreases the need for additional investigation and speeds the management of these epileptic disorders. This makes it possible to accurately define the location and the nature of the epileptogenic lesions related to seizures.
Keywords: Brain - pathology, Brain Diseases - diagnosis, Epilepsy - diagnosis, Hippocampus, Hippocampus, Humans, Magnetic Resonance Imaging - methods, Magnetic Resonance Imaging - methods, Seizures - diagnosis, Seizures, Febrile - diagnosis, Tomography, X-Ray Computed - methods, Brain - pathology, Brain Diseases - diagnosis, Epilepsy - diagnosis, Hippocampus, Humans, Magnetic Resonance Imaging - methods, Seizures - diagnosis, Seizures, Febrile - diagnosis, Tomography, X-Ray Computed - methods