Mengistu Getahun, Ewunetu Birrie Deresse, Johnston James C, Metaferia Guta Zenebe
Department of Neurology, Addis Ababa University, Ethiopia.
Ethiop Med J. 2014 Apr;52(2):57-66.
Epilepsy is arguably the most common neurological condition encountered by neurologists in Africa. Neuroimaging (CT and MRI) represents the most important recent contribution to the diagnosis, classification and management of the patient with epilepsy.
To describe the role of neuroimaging in the evaluation of Ethiopian patients with epilepsy, by identifying intracranial pathology, and formulating syndromic and etiological diagnoses.
We performed a retrospective review of neuroimaging in 181 patients with epilepsy presenting to a specialized referral hospital (Addis Ababa University Tikur Anbessa Teaching Hospital) and a private clinic (Yehuleshet Higher Clinic) in Addis Ababa, Ethiopia between September 2008 and August 2010. Each patient had an interictal EEG recording.
Neuroimaging demonstrated abnormal intracranial structural lesions in 65 of 181 or 35.9% of epileptic patients (31% with CT; 38% with MRI). Brain lesions were single in 28 (42.8%) and multiple in 23 (35.4%) patients. The lesions were lateralized in 35 patients (53.8%), with 23 (35.4%) on the left add 12 (18.5%) on the right. Twenty seven (41.5%) of these lesions originated in or involved the temporal or frontal lobes. Over one third of the lesions were lobar equally divided among temporal, frontal and parietal regions. The imaging findings demonstrated intracranial space occupying lesions (ICSOL) in 17 (9.4%) patients (with 64.7% brain tumors), cerebral infarctions in 15 (8.3%), cortical atrophy in 9 (5.0%), and gliosis in 7(3.9%). The interictal EEG recordings revealed epileptiform abnormalities in 60/181 patients (33.1%).
Neuroimaging detected intracranial pathology in more than one third of Ethiopian patients with epilepsy. A significant proportion of the cases demonstrated focal epileptiform discharges and non-epileptiform features with abnormal intracranial pathologies. Further prospective neuroimaging studies are recommended. Brain scan and EEG did help in the diagnosis, classification and treatment of epileptics.
癫痫可以说是非洲神经科医生遇到的最常见的神经系统疾病。神经影像学检查（CT和MRI）是近年来对癫痫患者诊断、分类及治疗最重要的贡献。
通过识别颅内病变，制定综合征及病因诊断，描述神经影像学检查在埃塞俄比亚癫痫患者评估中的作用。
我们对2008年9月至2010年8月期间在埃塞俄比亚亚的斯亚贝巴一家专业转诊医院（亚的斯亚贝巴大学提古雷安贝萨教学医院）和一家私人诊所（耶胡莱谢特高级诊所）就诊的181例癫痫患者的神经影像学检查进行了回顾性分析。每位患者均进行了发作间期脑电图记录。
神经影像学检查显示，181例癫痫患者中有65例（35.9%）存在颅内结构异常病变（CT检查发现异常的占31%；MRI检查发现异常的占38%）。脑病变患者中，单发的有28例（42.8%），多发的有23例（35.4%）。35例（53.8%）病变位于单侧，其中左侧23例（35.4%），右侧12例（18.5%）。这些病变中有27例（41.5%）起源于或累及颞叶或额叶。超过三分之一的病变位于脑叶，颞叶、额叶和顶叶分布均等。影像学检查结果显示，17例（9.4%）患者存在颅内占位性病变（ICSOL）（其中64.7%为脑肿瘤），15例（8.3%）为脑梗死，9例（5.0%）为皮质萎缩，7例（3.9%）为胶质增生。发作间期脑电图记录显示，181例患者中有60例（33.1%）存在癫痫样异常。
神经影像学检查在超过三分之一的埃塞俄比亚癫痫患者中检测到颅内病变。相当一部分病例表现为局灶性癫痫样放电和伴有颅内异常病变的非癫痫样特征。建议进一步开展前瞻性神经影像学研究。脑部扫描和脑电图检查确实有助于癫痫的诊断、分类及治疗。
