Abstract

: Seizure is a clinical manifestation of abnormal, excessive neuronal activity arising in the grey matter of the cerebral cortex. They are result of a shift in the normal balance of excitation and inhibition within the central nervous system. Clinicians all over the world face a common problem in the assessment of patients presenting with seizure disorder. MRI has reformed neuroimaging and provides the best method of non-invasive structural evaluation of the brain. MRI findings in a patient with seizure disorders may be extremely variable ranging from a normal scan to one showing a lesion indicated by altered signal intensity in different sequences. Materials and methods: A prospective study was conducted on 150 patients, aged 16-80 yrs, who presented with seizures and referred to the Department of Radiodiagnosis, NRI Medical College & Hospital, Chinakakani, Guntur, Andhra Pradesh, February 2022 to January 2023. Results: The most common age group in this study was 16-30 years with a male predominance. Most common type was GTCS seizures. MRI scans were abnormal in 88 (59%) cases. The common abnormalities noted were cerebral infarction with gliosis (13.3%), infections-tuberculoma (8.6%) and, NCC (6%) cerebral atrophy (5.3%), venous thrombosis (4%), neoplasm and PRES were (3.3%), temporal lobe epilepsy (2.6%), cerebral abscess (0.91%). Demyelination, metabolic and vascular causes comprised 2% of the total abnormal patients. Other causes of seizures comprised 4.6 % which include porencephalic cyst, schizencephaly, hemorrhagic metastasis, leptomeningeal carcinomatosis, cortical dysplasia, and hamartoma. Conclusion: Accurate identification of the underlying cause in seizure is very prudent for planning appropriate management. MRI is highly sensitive and specific in identifying the pathology which is responsible for seizures. In our study of 150 patients who clinically presented with seizures, infarcts, NCC, tuberculoma, atrophy, are the major etiological factors. Cerebral infarct with gliosis was the commonest MR abnormality observed. We conclude that MRI with seizure protocol plays a key role in the recognition of epileptogenic areas and thus for initiating appropriate therapy.

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