Book contents
- Seizure and Epilepsy Care
- Seizure and Epilepsy Care
- Copyright page
- Contents
- 1 How Do I Evaluate a First-Time Seizure?
- 2 How Do I Make an Epilepsy Diagnosis?
- 3 Which Antiseizure Medicines Treat Epilepsy and How Do I Pick?
- 4 How Can I Best Use EEG for Treating Epilepsy Patients?
- 5 What Are Common Epilepsy Imaging Findings in New Onset and Chronic Epilepsy Care?
- 6 How Do I Care for Patients in the Emergency Department and Inpatient Settings?
- 7 How Do I Manage Epilepsy Emergencies Like Status Epilepticus?
- 8 What Is the Best Long-Term Treatment Plan for Epilepsy Patients as an Outpatient?
- 9 What to Do When Your Patient Fails Two Antiseizure Medicines
- 10 Nonepileptic Events and General Psychiatric Care for Epilepsy Patients
- 11 What Are Essential Pediatric Epilepsy Clinical Diagnoses and Treatment Plans?
- Index
- References
5 - What Are Common Epilepsy Imaging Findings in New Onset and Chronic Epilepsy Care?
Published online by Cambridge University Press: 28 January 2023
Book contents
- Seizure and Epilepsy Care
- Seizure and Epilepsy Care
- Copyright page
- Contents
- 1 How Do I Evaluate a First-Time Seizure?
- 2 How Do I Make an Epilepsy Diagnosis?
- 3 Which Antiseizure Medicines Treat Epilepsy and How Do I Pick?
- 4 How Can I Best Use EEG for Treating Epilepsy Patients?
- 5 What Are Common Epilepsy Imaging Findings in New Onset and Chronic Epilepsy Care?
- 6 How Do I Care for Patients in the Emergency Department and Inpatient Settings?
- 7 How Do I Manage Epilepsy Emergencies Like Status Epilepticus?
- 8 What Is the Best Long-Term Treatment Plan for Epilepsy Patients as an Outpatient?
- 9 What to Do When Your Patient Fails Two Antiseizure Medicines
- 10 Nonepileptic Events and General Psychiatric Care for Epilepsy Patients
- 11 What Are Essential Pediatric Epilepsy Clinical Diagnoses and Treatment Plans?
- Index
- References
Summary
The use of imaging in epilepsy care is a powerful tool to show a patient why they have epilepsy. You can use it to correlate your semiology history with an imaging finding. Magnetic resonance imaging (MRI) is the most widely used modality for epilepsy care. Ordering an epilepsy protocol MRI on a 3 Tesla (3T) machine increases the likelihood of finding an epilepsy’s etiology. Common findings include stroke, tumor (i.e., ganglioglioma), hippocampal sclerosis, encephalocele, cortical dysplasia, heterotopia, polymicrogyria, or cavernoma. For MRI-negative epilepsy, additional tests to identify the epileptogenic region include PET (positron emission tomography) and SPECT (single photon emission computed tomography). Functional MRI (fMRI) can delineate brain areas critical for specific functions.Lastly, the use of CT (computed tomography) is limited to identification of acute findings like hemorrhage and tumors in new onset seizures.
- Type
- Chapter
- Information
- Seizure and Epilepsy CareThe Pocket Epileptologist, pp. 79 - 101Publisher: Cambridge University PressPrint publication year: 2023
References
Works Cited
Bernasconi, A, Cendes, F, Theodore, WH et al. Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: A consensus report from the International League Against Epilepsy Neuroimaging Task Force. Epilepsia. 2019;60(6):1054–68.Google ScholarPubMed
Wang, I, Bernasconi, A, Bernhardt, B et al. MRI essentials in epileptology: A review from the ILAE Imaging Taskforce. Epileptic Disord. 2020;22(4):421–37.CrossRefGoogle ScholarPubMed
Winston, GP, Micallef, C, Kendell, BE et al. The value of repeat neuroimaging for epilepsy at a tertiary referral centre: 16 years of experience. Epilepsy Res. 2013;105(3):349–55.Google Scholar
Opheim, G, van der Kolk, A, Markenroth Bloch, K et al. 7T Epilepsy Task Force Consensus recommendations on the use of 7T MRI in clinical practice. Neurology. 2021;96(7):327–41.Google Scholar
van Lanen, R, Colon, AJ, Wiggins, CJ et al. Ultra-high field magnetic resonance imaging in human epilepsy: A systematic review. Neuroimage Clin. 2021;30:102602.CrossRefGoogle ScholarPubMed
Villanueva-Meyer, JE, Mabray, MC, and Cha, S. Current clinical brain tumor imaging. Neurosurgery. 2017;81(3):397–415.CrossRefGoogle ScholarPubMed
Zimny, A, Zinska, L, Bladowska, J, Neska-Matuszewska, M, and Sasiadek, M. Intracranial lesions with high signal intensity on T1-weighted MR images: Review of pathologies. Pol J Radiol. 2013;78(4):36–46.Google ScholarPubMed
Newton, HB. Handbook of Neuro-oncology Neuroimaging. 2nd ed. Cambridge, MA: Academic Press; 2016. xxi.CrossRefGoogle Scholar
Kuzniecky, R, de la Sayette, V, Ethier, R et al. Magnetic resonance imaging in temporal lobe epilepsy: Pathological correlations. Ann Neurol. 1987;22(3):341–7.Google Scholar
Woermann, FG, Barker, GJ, Birnie, KD, Meencke, HJ, and Duncan, JS. Regional changes in hippocampal T2 relaxation and volume: a quantitative magnetic resonance imaging study of hippocampal sclerosis. J Neurol Neurosurg Psychiatry. 1998;65(5):656–64.CrossRefGoogle ScholarPubMed
Bernasconi, N, Natsume, J, and Bernasconi, A. Progression in temporal lobe epilepsy: Differential atrophy in mesial temporal structures. Neurology. 2005;65(2):223–8.CrossRefGoogle ScholarPubMed
Moran, NF, Lemieux, L, Kitchen, ND, Fish, DR, and Shorvon, SD. Extrahippocampal temporal lobe atrophy in temporal lobe epilepsy and mesial temporal sclerosis. Brain. 2001;124(pt. 1):167–75.CrossRefGoogle ScholarPubMed
Tsai, MH, Vaughan, DN, Perchyonok, Y et al. Hippocampal malrotation is an anatomic variant and has no clinical significance in MRI-negative temporal lobe epilepsy. Epilepsia. 2016;57(10):1719–28.CrossRefGoogle ScholarPubMed
Abou-Hamden, A, Lau, M, Fabinyi, G et al. Small temporal pole encephaloceles: A treatable cause of “lesion negative” temporal lobe epilepsy. Epilepsia. 2010;51(10):2199–202.CrossRefGoogle ScholarPubMed
Saavalainen, T, Jutila, L, Mervaala, E et al. Temporal anteroinferior encephalocele: An underrecognized etiology of temporal lobe epilepsy? Neurology. 2015;85(17):1467–74.Google Scholar
Campbell, ZM, Hyer, JM, Lauzon, S et al. Detection and characteristics of temporal encephaloceles in patients with refractory epilepsy. AJNR Am J Neuroradiol. 2018;39(8):1468–72.Google ScholarPubMed
Giulioni, M, Marucci, G, Martinoni, M et al. Epilepsy associated tumors: Review article. World J Clin Cases. 2014;2(11):623–41.CrossRefGoogle ScholarPubMed
Rosenow, F, Alonso-Vanegas, MA, Baumgartner, C et al. Cavernoma-related epilepsy: Review and recommendations for management: Report of the Surgical Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2013;54(12):2025–35.Google Scholar
Blumcke, I, Thom, M, Aronica, E et al. The clinicopathologic spectrum of focal cortical dysplasias: A consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia. 2011;52(1):158–74.CrossRefGoogle Scholar
Duncan, JS, Winston, GP, Koepp, MJ, and Ourselin, S. Brain imaging in the assessment for epilepsy surgery. Lancet Neurol. 2016;15(4):420–33.Google Scholar
Barkovich, AJ, Guerrini, R, Kuzniecky, RI, Jackson, GD, and Dobyns, WB. A developmental and genetic classification for malformations of cortical development: Update 2012. Brain. 2012;135(pt. 5):1348–69.CrossRefGoogle ScholarPubMed
Donkol, RH, Moghazy, KM, and Abolenin, A. Assessment of gray matter heterotopia by magnetic resonance imaging. World J Radiol. 2012;4(3):90–6.Google Scholar
Takanashi, J and Barkovich, AJ. The changing MR imaging appearance of polymicrogyria: A consequence of myelination. Am J Neuroradiol. 2003;24(5):788–93.Google ScholarPubMed
Strambo, D, Rey, V, Rossetti, AO et al. Perfusion-CT imaging in epileptic seizures. J Neurol. 2018;265(12):2972–9.Google Scholar
Gonzalez-Cuevas, M, Coscojuela, P, Santamarina, E et al. Usefulness of brain perfusion CT in focal-onset status epilepticus. Epilepsia. 2019;60(7):1317–24.Google Scholar
Rosenow, F and Lüders, H. Presurgical evaluation of epilepsy. Brain. 2001;124(pt. 9):1683–700.CrossRefGoogle ScholarPubMed
Siclari, F, Prior, JO, and Rossetti, AO. Ictal cerebral positron emission tomography (PET) in focal status epilepticus. Epilepsy Res. 2013;105(3):356–61.CrossRefGoogle ScholarPubMed
O’Brien, TJ, So, EL, Mullan, BP et al. Subtraction ictal SPECT co-registered to MRI improves clinical usefulness of SPECT in localizing the surgical seizure focus. Neurology. 1998;50(2):445–54.Google ScholarPubMed
O’Brien, TJ, So, EL, Mullan, BP et al. Subtraction peri-ictal SPECT is predictive of extratemporal epilepsy surgery outcome. Neurology. 2000;55(11):1668–77.CrossRefGoogle ScholarPubMed
Desai, A, Bekelis, K, Thadani, VM et al. Interictal PET and ictal subtraction SPECT: Sensitivity in the detection of seizure foci in patients with medically intractable epilepsy. Epilepsia. 2013;54(2):341–50.Google Scholar
Kesavadas, C and Thomas, B. Clinical applications of functional MRI in epilepsy. Indian J Radiol Imaging. 2008;18(3):210–17.Google ScholarPubMed
Szaflarski, JP, Gloss, D, Binder, JR et al. Practice guideline summary: Use of fMRI in the presurgical evaluation of patients with epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2017;88(4):395–402.CrossRefGoogle Scholar
Zijlmans, M, Huiskamp, G, Hersevoort, M et al. EEG-fMRI in the preoperative work-up for epilepsy surgery. Brain. 2007;130(pt. 9):2343–53.CrossRefGoogle ScholarPubMed