https://doi.org/10.4081/acbr.2022.188
0.35 Tesla magnetic resonance imaging findings in a cohort of 399 seizure patients. Experience from a single centre in Nigeria
Submitted: 27 December 2021
Accepted: 7 February 2022
Published: 3 March 2022
Accepted: 7 February 2022
Abstract Views: 796
PDF: 153
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Epilepsy/seizures are major indications for brain imaging in clinical neurology. Structural lesions that may cause seizures are numerous and are defined using various neuroimaging techniques, including magnetic resonance imaging. The resolution of MRI allows for better fine ultra-structural lesions delineation. The aim of this study was to describe the pattern and frequency of structural brain lesions in MRI of patients with seizures and no clinically evident focal neurological signs. This was a retrospective, descriptive study carried out in a private hospital in Enugu, South East Nigeria to review all MRI results of patients who presented with seizures without clinical evidence of focal neurologic deficits. The MRI reports of two-third of the patients (47.9%) revealed focal lesions and about a third of the patients (32.2%) had normal findings. The structural lesions reported were mostly brain tumors (16%), stroke (9.5%), central nervous system infections (6.5%), brain malformation (6%) and encephalomalacia/gliosis (5%). Frequency of focal lesions clearly increased with age. Young patients were mostly associated with normal findings. Brain tumors and stroke were noted to occur more in the middle and aged patients respectively. Brain Magnetic Resonance Imaging remains a useful tool in the workup of patients with seizures without neurologic deficits. Treatable lesions can easily be revealed using this imaging modality.
Gupta V, Bronen R A. MRI: Overview of MR Techniques for Epilepsy. In Chugani H eds. Neuroimaging in Epilepsy. University Press Scholarship Online Oxford Scholarship Online; 2011. doi: 10.1093/acprof:oso/9780195342765.001.000
DOI: https://doi.org/10.1093/acprof:oso/9780195342765.003.0002
Cendes F, Theodore W H, Brinkmann B H, et al. Neuroimaging of epilepsy Handb Clin Neurol 2016;136:985–1014.
DOI: https://doi.org/10.1016/B978-0-444-53486-6.00051-X
Whelan CD, Altmann A, Botı JA, et al. Structural brain abnormalities in the common epilepsies assessed in a worldwide ENIGMA study. Brain. 2018;141:391-408.
DOI: https://doi.org/10.1093/brain/awx341
Prado J A-L. Structural magnetic resonance imaging in epilepsy. Radiología 2012;54:9-20.
DOI: https://doi.org/10.1016/j.rxeng.2011.07.001
Bano S, Yadav SN, Chaudhary V, Garga UC. Neuroimaging in epilepsy. J PediatrNeurosci 2011;6:19-26.
Zhao X, Zhou Z, Zhu W, Xiang H. Role of conventional magnetic resonance imaging in the screening of epilepsy with structural abnormalities: a pictorial essay Am J Nucl Med Mol Imaging 2017;7:126-37.
Wheless J W, Carmant L, Bebin M, et al. Magnetic resonance imaging abnormalities associated with vigabatrin in patients with epilepsy. Epilepsia 2009;50:195–205.
DOI: https://doi.org/10.1111/j.1528-1167.2008.01896.x
Ezeala-Adikaibe AB, Ohaegbulam SC, Ndubuisi CA. The pattern of significant lesions found in computerized tomography scan of recurrent seizure patients at a center in Enugu, Nigeria. Niger J Clin Pract 2017;20:1289-93.
DOI: https://doi.org/10.4103/njcp.njcp_215_16
Ogunniyi A, Adeyinka A, Fagbemi SO, et al. Computerized tomographic findings in adolescent and adult Nigerian epileptics. West Afr J Med 1994;13:128‑31.
Ndubuisi CA, Mezue WC, Ohaegbulam SC, et al. Neuroimaging findings in pediatric patients with seizure from an institution in Enugu. Niger J Clin Pract 2016;19:121-7.
DOI: https://doi.org/10.4103/1119-3077.173712
Bernasconi A, Cendes F, Theodore WH, et al. Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: A consensus report from the International League Against Epilepsy Neuroimaging Task Force. Epilepsia 2019;60:1054–1068.
DOI: https://doi.org/10.1111/epi.15612
NICE. Epilepsy in adults Quality standard Published: 28 February 2013. Available from: www.nice.org.uk/guidance/qs26
Longe AC, Omojola MF. Computed tomographic brain scan findings in Saudi epileptic patients. East Afr Med J 1994;71:567‑70.
Mir S, Dr. Ahmad M, Dr. Kumari R. Assessment of CT scans findings in patients with seizures: An Imaging perspective. Sch J App Med Sci 2016;4:3909-15.
King MA, Newton MR, Jackson GD, et al. Epileptology of the first-seizure presentation: a clinical, electroencephalographic, and magnetic resonance imaging study of 300 consecutive patients. Lancet 1998:352:1007-11.
DOI: https://doi.org/10.1016/S0140-6736(98)03543-0
Berg AT, Testa FM, Levy SR, Shinnar S. Neuroimaging in children with newly diagnosed epilepsy: A community-based study. Pediatrics 2000;106:527-32.
DOI: https://doi.org/10.1542/peds.106.3.527
Passaro EA. Neuroimaging in Epilepsy. Available from: https://emedicine.medscape.com/article/1155295
Von Oertzen J, Urbach H, Jungbluth S, et al. Standard magnetic resonance imaging is inadequate for patients with refractory focal epilepsy. J Neurol Neurosurg Psych 2002;73:643-7.
DOI: https://doi.org/10.1136/jnnp.73.6.643
Wieshmann UC. Clinical application of neuroimaging in epilepsy. J Neurol Neurosurg Psych 2003;74:466-70.
DOI: https://doi.org/10.1136/jnnp.74.4.466
Ezeala-Adikaibe BA, Orjioke C, Ekenze O, et al. Prevalence of active convulsive epilepsy in an urban slum in Enugu South East Nigeria. Seizure 2016;35:100–105.
DOI: https://doi.org/10.1016/j.seizure.2015.12.010
Onwuekwe IO, Onodugo OD, Ezeala-Adikaibe B, et al. Pattern and presentation of epilepsy in Nigerian Africans: A study of trends in the southeast. Trans R Soc Trop Med Hyg 2009;103:785-9.
DOI: https://doi.org/10.1016/j.trstmh.2009.04.010
Englot DJ, Chang EC, Vecht CJ. Epilepsy and brain tumors. Handb Clin Neurol 2016;134:267–85.
DOI: https://doi.org/10.1016/B978-0-12-802997-8.00016-5
de Groot M, Reijneveld JC, Aronica E, Heimans JJ. Epilepsy in patients with a brain tumour: focal epilepsy requires focused treatment Brain 2012:135;1002–16.
DOI: https://doi.org/10.1093/brain/awr310
Obajimi MO, Fatunde OJ, Ogunseyinde AO, et al. Computed tomography and childhood seizure disorder in Ibadan. West Afr J Med 2004;23:167‑72.
DOI: https://doi.org/10.4314/wajm.v23i2.28112
WHO. Epilepsy: a public health imperative. World Health Organization; 2019
Forsgren L, Beghi E, Oun A, Sillanpaa M. The epidemiology of epilepsy in Europe: a systematic review. Eur J Neurol 2005;12:245–53.
DOI: https://doi.org/10.1111/j.1468-1331.2004.00992.x
Federal Republic of Nigeria 2006 Population and Housing Census. Population Distribution by Age and Sex. State and Local Government Area. National Population Commission Abuja: Nigeria, 2010.
Leone MA, Tonini MC, Bogliun G,Gionco M, Tassinari T, Bottacchi E, et al. On behalf of ARES (Alcohol Related Seizures) Study Group. Risk factors for a first epileptic seizure after stroke: a case control study. J Neurol Sci 2009; 277:138–142
DOI: https://doi.org/10.1016/j.jns.2008.11.004
Ferlazzo E, Gasparini S, Beghi E, Sueri C, Ruso E, Leo A et al. On behalf of the Epilepsy Study Group of the Italian Neurological Society. Epilepsy in cerebrovascular diseases: review of experimental and clinical data with meta-analysis of risk factors. Epilepsia 2016;57:1205–14.
DOI: https://doi.org/10.1111/epi.13448
Eriksson H, Wirdefeldt K, Åsberg S, Zelano J. Family history increases the risk of late seizures after stroke. Neurology 2019;93:e1964-70.
DOI: https://doi.org/10.1212/WNL.0000000000008522
Graham NSN, Crichton S, Koutroumanidis M, et al. Incidence and associations of poststroke epilepsy the prospective south london stroke register. Stroke 2013;44:605-11.
Graham NS, Crichton S, Koutroumanidis M, et al. Incidence and associations of poststroke epilepsy: the prospective South London Stroke Register. Stroke 2013;44:605-11.
DOI: https://doi.org/10.1161/STROKEAHA.111.000220
Ekenze OS, Adikaibe EAB, Obinna O, et al. The prevalence of stroke survivors in urban slums in Enugu, Nigeria. Open J Prev Med 2019;9:51-67.
DOI: https://doi.org/10.4236/ojpm.2019.96006
Millogo A, Nitiema P, Carabin H, et al. Prevalence of neurocysticercosis among people with epilepsy in rural areas of Burkina Faso. Epilepsia 2012;53:2194-202.
DOI: https://doi.org/10.1111/j.1528-1167.2012.03687.x
Parkinson D, Bachers G. Arteriovenous malformations. J Neurosurg 1980;53:285–99.
DOI: https://doi.org/10.3171/jns.1980.53.3.0285
Turjman F, Massoud TF, Sayre JW, et al. Epilepsy associated with cerebral arteriovenous malformations: a multivariate analysis of angioarchitectural characteristics. Am J Neuroradiol 1995;16:345–50.
Moriarity JL, Wetzel M, Clatterbuck RE, et al. The natural history of cavernous malformations: a prospective study of 68 patients. Neurosurgery 1999;44:1166 –71.
DOI: https://doi.org/10.1227/00006123-199906000-00003
Josephson CB, Leach JP, Duncan R, et al. Seizure risk from cavernous or arteriovenous malformations Prospective population-based study. On behalf of the Scottish Audit of Intracranial Vascular Malformations (SAIVMs) steering committee and collaborators. Neurology 2011;76;1548-54.
DOI: https://doi.org/10.1212/WNL.0b013e3182190f37
Unterberger I, Bauer R, Walser G W, Bauer G. Corpus callosum and epilepsies. Seizure 2016;37:55–60.
DOI: https://doi.org/10.1016/j.seizure.2016.02.012
Crawford PM, West CR, Chadwick DW, Shaw MD. Arteriovenous malformations of the brain: natural history in unoperated patients. J Neurol Neurosurg Psychiatry 1986;49:1–10.
DOI: https://doi.org/10.1136/jnnp.49.1.1
Frey L C. Epidemiology of Posttraumatic Epilepsy: A Critical Review. Epilepsia 2003;44:11–7.
DOI: https://doi.org/10.1046/j.1528-1157.44.s10.4.x
Temkin N R. Risk Factors for Posttraumatic Seizures in Adults. Epilepsia 2003;44:18–20.
DOI: https://doi.org/10.1046/j.1528-1157.44.s10.6.x
How to Cite
Ezeala-Adikaibe, B. A., Oti, B., Ohaegbulam, S. C., Okwuonodulu, O., & Ndubuisi, C. (2022). 0.35 Tesla magnetic resonance imaging findings in a cohort of 399 seizure patients. Experience from a single centre in Nigeria. Annals of Clinical and Biomedical Research, 3(1). https://doi.org/10.4081/acbr.2022.188
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.