Toledo Manuel, Sarria-Estrada Silvana, Quintana Manuel, Auger Cristina, Salas-Puig Xavier, Santamarina Estevo, Vert Carla, Rovira Alex
Epilepsy Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.
Clin Neurol Neurosurg. 2013 Oct;115(10):2111-6. doi: 10.1016/j.clineuro.2013.07.039. Epub 2013 Aug 7.
The finding of cerebral epileptogenic lesions in magnetic resonance (MR) has demonstrated to be a relevant prognostic factor for potential surgical candidates. In a series of consecutive adults with focal onset epilepsy, we investigated the yield of 3T MR imaging for detecting epileptogenic cerebral lesions.
We prospectively recruited 161 adult patients with a diagnosis of focal epilepsy, all of whom underwent standardized MR imaging study performed with a 3T magnet.
Lesion-related epilepsy was observed in 48% of patients, and 12% of cryptogenic patients showed subtle or non-specific lesions related to the epileptogenic source. The most common findings were focal cortical dysplasia and vascular lesions, followed by mesial temporal sclerosis, tumors, and scars from previous cerebral injuries. Patients older than 72 years were more likely to have vascular epilepsy.
Diagnostic assessment using a standardized 3T MR imaging protocol for focal-onset epilepsy detects lesions in nearly half the patients. Our results indicate that elders with focal epilepsy should be searched for vascular lesions.
磁共振成像（MR）检查发现的脑致痫性病变已被证明是潜在手术候选者的一个重要预后因素。在一系列连续性局灶性起病癫痫的成年患者中，我们研究了3T MR成像检测脑致痫性病变的阳性率。
我们前瞻性招募了161例诊断为局灶性癫痫的成年患者，所有患者均接受了使用3T磁体进行的标准化MR成像检查。
48%的患者观察到与病变相关的癫痫，12%的隐源性患者显示出与致痫源相关的细微或非特异性病变。最常见的发现是局灶性皮质发育不良和血管病变，其次是内侧颞叶硬化、肿瘤以及既往脑损伤留下的瘢痕。72岁以上的患者更有可能患有血管性癫痫。
采用标准化3T MR成像方案对局灶性起病癫痫进行诊断评估，在近半数患者中检测到病变。我们的结果表明，对于局灶性癫痫的老年患者，应排查血管性病变。
