PT  - JOURNAL ARTICLE
AU  - B S Brooks
AU  - D W King
AU  - T el Gammal
AU  - K Meador
AU  - F Yaghmai
AU  - J N Gay
AU  - J R Smith
AU  - H F Flanigin
TI  - MR imaging in patients with intractable complex partial epileptic seizures.
DP  - 1990 Jan 01
TA  - American Journal of Neuroradiology
PG  - 93--99
VI  - 11
IP  - 1
4099  - http://www.ajnr.org/content/11/1/93.short
4100  - http://www.ajnr.org/content/11/1/93.full
SO  - Am. J. Neuroradiol.1990 Jan 01; 11
AB  - Detailed neurologic studies, high-field-strength MR imaging, and CT scanning were performed preoperatively in 53 patients with intractable complex partial seizures who underwent surgical treatment for epilepsy. Macroscopic structural (tumoral or vascular) lesions were found in 28% of patients. The remainder had pathologic findings consistent with mesial temporal gliosis. Tumors were found in 22% of the patients and were benign or of low-grade malignancy in every case. MR was accurate in the preoperative diagnosis of structural lesions, including very small occult tumors and cryptic vascular malformations. In patients with mesial temporal gliosis, there was correlation between the MR observation of a unilaterally dilated anterior temporal horn and the EEG-identified seizure focus and side of temporal lobectomy. However, MR demonstrated T2-weighted signal abnormalities correlating with the epileptogenic focus in only 8% of cases of mesial temporal gliosis. MR provided useful information in 28% of patients who underwent surgery for refractory complex partial epilepsy. MR obviated invasive EEG monitoring in 93% of the patients with structural lesions. MR was useful in only 8% of the patients with pathologic changes of mesial temporal gliosis.