QUANTITATIVE CEREBRAL MRI IN EPILEPTIC PATIENTS

Objectives - To determine cerebral atrophy parameters on MRI images of epileptic patients. Material and methods - Examination of the brain w as performed in a 0.5 Tesla magnet in 32 women with epilepsy and 36 fe male healthy controls. Fifteen patients were classified to have genera lised epilepsy and 17 had partial seizure onset. Epileptic patients wi th structural brain changes were excluded. At midsagittal level the ar ea of corpus callosum, cerebrum and cerebellum were selected as atroph y parameters. At transverse level the ventricle-brain ratio (VBR) as a measure of overall cerebral atrophy, bifrontal ratio (BFR) reflecting atrophy in the area of the frontal horns, bicaudate ratio (BCR) and b ioccipital ratio (BOR) were calculated to evaluate atrophy in the regi on of nucleus caudatus as well as in the occipital area. Results - The mean values of VBR were significantly larger in the two epileptic gro ups than in controls, p = 0.0003. No significant difference in mean VB R were found between focal and generalised seizure onset epilepsy. Als o significant decreased cerebellar area on midsagittal section was det ected in epileptic patients with partial onset epilepsy compared with controls, p = 0.037. Atrophy was not associated with type and duration of epilepsy, but VBR and age were positively associated in patients w ith generalised onset seizures. Conclusion - These findings suggest ge neral brain atrophy to be present in epileptic patients including thos e with partial epilepsy. Whether atrophy in epileptic patients occurs as a consequence of disease-related factors like hypoxia or treatment with antiepileptic drugs has to be investigated in a prospectively des igned study.