Magnetic Resonance Imaging of the Brain in Epileptic Adult Patients: Experience in Ramathibodi Hospital
Anusorn Solosrungruang MD*, Jiraporn Laothamatas MD*, Yotin Chinwarun MD, PhD**
Affiliation : * Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ** Department of Medicine (Neurology Division), Faculty of Medicine, Pramongkutklao Royal Army Hospital and Medical College
Objective : The purpose of the present study was to classify the imaging structural abnormalities of epileptic
adult patients referred for magnetic resonance imaging (MR imaging) of the brain at Ramathibodi Hospital
and to correlate with the clinical data and EEG.
Materials and Methods : MR imaging of 91 adult epileptic patients (age ranging from 15-85 years old with an
average of 36.90 years old) were retrospectively reviewed and classified into eight groups according to
etiologies. Then clinical data and EEG correlations were analyzed using the Kappa analysis. All of the MR
imaging of the brain were performed at Ramathibodi Hospital from January 2001 to December 2002.
Results : Secondary generalized tonic clonic seizure was the most common clinical presenting seizure type.
Extra temporal lobe epilepsy was the most common clinical diagnosis. Of the thirty-three patients who under-
went EEG before performing MR imaging, 17 had normal EEG. From MR imaging, temporal lobe lesion was
the main affected location and mesial temporal sclerosis (MTS) was the most common cause of the epilepsy in
patients. For age group classification, young adult (15-34 years old) and adult (35-64 years old) age groups,
MTS was the most common etiology of epilepsy with cortical dysplasia being the second most common cause
for the first group and vascular disease for the latter group. For the older age group (> 64 years old), vascular
disease and idiopathic cause were equally common etiologies. MRI, EEG findings, and clinical data were all
concordant with statistical significance.
Conclusion : MRI is the non-invasive modality of choice for evaluation of the epileptic patients. The result is
concordant with the clinical and EEG findings. It can detect and localize the structural abnormality accu-
rately and is useful in the treatment planning.
Keywords : Magnetic resonance imaging, MRI, Epilepsy, Seizure, Adult patient
