EARLY DETECTION OF ABNORMALITIES IN PARTIAL EPILEPSY USING MAGNETIC-RESONANCE

The incidence of brain abnormalities determined by magnetic resonance in 30 consecutive children presenting with intractable complex partial seizures is reported. Images were optimised to visualise the hippocam pus and cortical grey matter. Abnormalities of the hippocampus or temp oral lobe were seen in all 19 children with clinical features of tempo ral lobe epilepsy and in six of the seven children with clinically unl ocalised epilepsy. By contrast, in the four children with a clinical d iagnosis of extratemporal epilepsy, no temporal or hippocampal abnorma lities were seen. Generalised cortical abnormalities of uncertain sign ificance were found in a total of 14 children from all groups. The ide ntification of focal brain abnormalities using optimised magnetic reso nance imaging enables early non-invasive assessment of children with i ntractable seizure disorders and the identification of patients for wh om epilepsy surgery may be appropriate. It may also lead to a better u nderstanding of the structural basis of intractable epilepsy, and ther eby contribute to early treatment decisions.