Nieto-Salazar Maria A, Velasquez-Botero Felipe, Toro-Velandia Adriana C, Saldana-Rodriguez Ericka A, Rodriguez-Rodriguez Miguel E, Gupta Aditi, Cheeti Srinidhi, Huerta-Rengifo Claudia, Pavón-Enamorado Fredy R, Rodezno Carmen M C, Medina Patrick S D, De-Sario-Velasquez Gioacchino D M S, Sah Biki K, Shaheen Fatima, Shree Anagha, Sah Rajan K
Juan N. Corpas University.
CES University.
Ann Med Surg (Lond). 2023 Feb 7;85(2):73-75. doi: 10.1097/MS9.0000000000000155. eCollection 2023 Feb.
Epilepsy is the most common neurological disorder that affects ~1-2% of the global population, leading to presentation in the emergency room. The neuroimaging modalities have an important application in diagnosing new onset unprovoked seizures and epilepsy. This article discusses the various neuroimaging modalities for diagnosing seizures and epilepsy and addresses that the MRI is the investigation of choice, and urgent imaging is more commonly done by computed tomography in patients with new-onset seizures. The goal of the article was to diagnose seizures and epilepsy for early intervention to prevent complications or damage to the brain. MRI detects even small cortical epileptogenic lesions, whereas computed tomography is used in screening, diagnosis, evaluation, and monitoring of the prognosis of seizures in children. Magnetic resonance spectroscopy provides biochemical measurements of reduced N-acetyl aspartate and increased creatinine and choline in dysfunctioning epileptic zones. Volumetric MRI is very sensitive and specific in determining seizures originating in extratemporal and extrahippocampal sites. Even though diffusion tensor magnetic resonance imaging has a limited role, it is used in specific pediatric patient groups with temporal lobe epilepsy. Functional radionuclide imaging modalities (positron emission tomography and single-photon emission computerized tomography) are increasingly significant for the identification of the epileptic region. Furthermore, the authors recommend the use of artificial intelligence and further research on imaging modalities for early diagnosis of seizures and epilepsy.
癫痫是最常见的神经系统疾病,影响着全球约1%-2%的人口,常导致患者前往急诊室就诊。神经影像学检查方法在诊断新发特发性癫痫发作及癫痫方面具有重要应用。本文讨论了用于诊断癫痫发作及癫痫的各种神经影像学检查方法,并指出磁共振成像(MRI)是首选的检查手段,而对于新发癫痫发作患者,紧急成像更常用计算机断层扫描(CT)。本文的目的是诊断癫痫发作及癫痫以便早期干预,预防并发症或脑损伤。MRI能够检测出即使是很小的皮质癫痫病灶,而CT则用于儿童癫痫发作的筛查、诊断、评估及预后监测。磁共振波谱能够对功能异常的癫痫区域内N-乙酰天门冬氨酸减少、肌酸和胆碱增加进行生化测量。容积MRI在确定起源于颞叶外和海马体外部位的癫痫发作方面非常敏感且具有特异性。尽管扩散张量磁共振成像的作用有限,但它用于特定的颞叶癫痫儿科患者群体。功能性放射性核素成像检查方法(正电子发射断层扫描和单光子发射计算机断层扫描)在识别癫痫区域方面越来越重要。此外,作者建议使用人工智能,并进一步研究成像检查方法以早期诊断癫痫发作及癫痫。