Abstract:
Background: Mesial temporal lobe epilepsy is the most common form of epilepsy. Since its pathophysiological substrate is usually related to
hippocampal sclerosis, the seizures are typically resistant to antiepileptic drugs and surgical treatment is considered in most patients. Defining
the affected region on medical imaging is of paramount importance in this situation. The study aimed to evaluate the role of brain magnetic
resonance imaging (MRI) in patients with suspected mesial temporal lobe epilepsy and its ability to reveal the responsible epileptogenic focus.
Material and methods: The study included 96 patients aged 3 to 48 years old with clinical suspicion of temporal lobe epilepsy who underwent
a brain MRI scan at the Medpark International Hospital in the period 25.01.2017 – 25.01.2018. The scans were performed on a Siemens
Essenza 1.5 Tesla MRI scanner using a specially designed epilepsy imaging protocol (sag T1W, T2W, T2-tirm, DWI). Additional sequences
(such as cor T2 FLAIR, T1 IR + contrast) were also included if required.
Results: From a total of 96 patients, brain MRI revealed the potential epileptogenic region in 27 (28%) cases. The MRI findings in these
patients included increased signal intensity in the region of hippocampus (23 patients), hippocampal atrophy or volume loss (19 patients),
enlarged temporal horn (11 patients), smaller temporal lobe (10 patients) and collateral white matter atrophy (6 patients).
Conclusions: In our study, mesial temporal sclerosis was the most common identifiable cause of seizures. Even though brain MRI features
may vary, the increased hippocampal signal intensity was the most consistent finding.
Description:
Department of Radiology and Imaging, Nicolae Testemitsanu State University of Medicine and Pharmacy
Chisinau, the Republic of Moldova,
The IVth Congress of Radiology and Medical Imaging of the Republic of Moldova with international participation, Chisinau, May 31 – June 2, 2018