Ho Kevin, Lawn Nicholas, Bynevelt Michael, Lee Judy, Dunne John
Radiology Department (KH), Fremantle Hospital; Department of Neurology (NL, JL, JD), Royal Perth Hospital; and Radiology Department (MB), Sir Charles Gairdner Hospital, Perth, Western Australia.
Neurol Clin Pract. 2013 Oct;3(5):398-403. doi: 10.1212/CPJ.0b013e3182a78f25.
The role of neuroimaging in the assessment of a first-ever seizure has not been well-defined, in particular the utility of MRI when CT is normal. The results of neuroimaging (CT brain, MRI brain, or both) in 1,013 adults with first-ever unprovoked seizure were correlated with clinical features and seizure outcome. Epileptogenic lesions were identified in 29%. Of patients with a normal CT who also had MRI, 12% had an epileptogenic lesion on MRI, the strongest independent predictor of which was a focal abnormality on EEG. Patients with an epileptogenic lesion had a higher risk of seizure recurrence, including when this was only evident on MRI.
神经影像学在首次发作癫痫评估中的作用尚未明确界定，尤其是在CT正常时MRI的效用。对1013例首次发生特发性癫痫的成年人进行神经影像学检查（头颅CT、头颅MRI或两者皆做），并将结果与临床特征及癫痫发作结局进行关联分析。29%的患者发现有癫痫病灶。CT正常且做了MRI的患者中，12%在MRI上发现有癫痫病灶，其中最强的独立预测因素是脑电图上的局灶性异常。有癫痫病灶的患者癫痫复发风险更高，即便病灶仅在MRI上显示时也是如此。
