A computed tomographic studies on epilepsy

Bae, H S

Abstract

140 patients with epileptic seizure were studied by CT during the period from Feb. 1979 to Aug. 1979 in theDepartment of Radiology, College of Medicine, Hanyang University. Those findings on CT and clinical recordsincluding EEG findings were reviewed. The results were as follows; 1. Age distribution of the total 140 patientswas broad ranging from 1 month to 63 years. 73.5% of patients was below the age of 30. The patient population wascomprised of 93 males and 47 females, and its male to female ratio was 2:1. 2. The types of epileptic seizure wereclassified according to the international League against Epilepsy. 42.9% of patients had primary generalizedseizure, 47.1% with partial seizure, and 10% with non-classifiable seizure. 3. As additional symptoms and signsexcept seizure, headache was most common, and the next was nausea and vomiting. Uncommonly, there were alsoinsomnia, personality change, and memory disturbance. 4. 37.1% of patients had less than 1 month of seizurehistory, 19.3% between 1 year and 5 years. 5. EEG findings were available in 41patients, and normal in 15 cases.26 patients revealed abnormal findings. Among those abnormal findings focal slowing was appeared in 19.5% andgeneralized slowing in 17.1%. 6. 52% of patients showed abnormal findings on CT. The msot common abnormal findingwas focal low density(30%), and the next was diffuse hydrocephalus(7.1%), After contrast infusion, contrastenhancement was occured in cases with focal low density, focal high or isodense mass density. In patients withfocal low density, ring or nodular enhancement were common, and diffuse or serpentine enhancement in focal high orisodense mass density. 7. The frequency of structural anormalities on CT was more common in patients below the ageof 10 and over 30 than other age groups. The epiepsy starting below 10 and over 30 years of age showed structuralabnormalities in 63.6-100%. 8. The patients who had less than 6 months of history revealed more abnormal findingsthan the patients with over 6 months of history. And most of the abnormal findings in the latter were atrophiclesion. 50% of patients with primary genralized seizure and 54.5% of patients with partial seizure revealedabnormal findings on CT. 9. EEG was done in 41 cases. 23 out of 41 patients revealed normal CT and 18 patientsrevealed abnormal CT. In patients with normal EEG, 9 patients revealed abnormal findings on CT. 8 out of those 9 patients showed focal low density. So, there was no significant correlation between EEG and CT. 10. Most of thelesions on CT were located in the supratentorial region, particularly in the frontal and parietal lobe. There werepatients who had lesions in the posterior fossa, one in the brain stem and the other in the vermis. 11. Thediagnosis based on the CT findings included brain tumor(9.3%), cerebral infarct (7.9%), granuloma(5.7%), corticalatrophy(5%), and calcification (5%) respectively.