Kilpatrick C J, Tress B M, O'Donnell C, Rossiter S C, Hopper J L
Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Epilepsia. 1991 May-Jun;32(3):358-64. doi: 10.1111/j.1528-1157.1991.tb04664.x.
The value of magnetic resonance imaging (MRI) in investigation of patients with late-onset epilepsy has not been studied systematically. We evaluated prospectively the usefulness of MRI in 50 patients with late-onset epilepsy in whom a computed tomography (CT) scan was normal (32), did not allow a definitive diagnosis to be made (12), or showed irrelevant lesions (6). Patients were assessed clinically and had an EEG, and CT and MRI scans were reported by one neuroradiologist blinded to clinical and laboratory data. Of the 32 patients with a normal CT scan, MRI was normal in 20, showed irrelevant ischemic lesions in 8, and showed the cause of seizures in 4 patients. Of the 12 patients with nondiagnostic CT, MRI clarified the diagnosis in 5 and was normal in 2 patients. In 6 patients, both scans showed irrelevant ischemic lesions, and in 1 patient MRI showed a relevant additional lesion. The incidence of MRI-detected white matter ischemic lesions was no greater than in an age- and sex-matched group of subjects without seizures. MRI was diagnostic in 32% of the patients with partial seizures and/or focal EEG findings, as compared with 0% of patients without focal features (p less than 0.01). We conclude that MRI is useful in investigation of patients with late-onset epilepsy with focal features.
磁共振成像（MRI）在迟发性癫痫患者检查中的价值尚未得到系统研究。我们前瞻性地评估了MRI对50例迟发性癫痫患者的效用，这些患者的计算机断层扫描（CT）结果为正常（32例）、无法做出明确诊断（12例）或显示无关病变（6例）。对患者进行了临床评估并进行了脑电图检查，CT和MRI扫描结果由一位对临床和实验室数据不知情的神经放射科医生报告。在32例CT扫描正常的患者中，MRI正常的有20例，显示无关缺血性病变的有8例，显示癫痫发作病因的有4例。在12例CT检查未明确诊断的患者中，MRI明确了5例的诊断，2例正常。在6例患者中，两种扫描均显示无关缺血性病变，1例患者MRI显示有相关额外病变。MRI检测到的白质缺血性病变的发生率不高于年龄和性别匹配的无癫痫发作受试者组。在有部分性癫痫发作和/或局灶性脑电图表现的患者中，32%的患者MRI具有诊断价值，而无局灶性特征的患者中这一比例为0%（p<0.01）。我们得出结论，MRI对有局灶性特征的迟发性癫痫患者的检查有用。
