Clinical, EEG and MRI Findings in Newly Referred Seizure Patients

J Korean Neurol Assoc > Volume 12(1); 1994 > Article

Journal of the Korean Neurological Association 1994;12(1): 30-40.

새로이 전원된 간질환자에서의 임상, 뇌파 및 핵자기공명영상 소견

김옥준, 박수철,이병인,김동익

연세대학교 신경과, 방사선과.

Clinical, EEG and MRI Findings in Newly Referred Seizure Patients

Ok Jun Kim, M.D., Su Chul Park, M.D., Byung In Lee, M.D., Dong Ik Kim M.D.,

Department of Neurology& Radiology, Yonsei University College of Medicine

Abstract

Clinical, EEG and MRI assessments were conducted in 320 consecutive seizure patients referred to the Yonsei Epilepsy Clinic from october 1, 1991 to Feburary 28. 1993 Clinical assessment suggested that 91.9% of our patients had partial seizures and only 3.1% had generalized seizures. Among partial seizures. Temporal lobe seizure uas considered in 37.5%, localization undetermined partial seizure in 29.7%, extratemporal lobe seizure in 24.7%. Correlation with EEG findings in these patients showed disconcordance rate of 34.6% in generalized seizure, 29.1% in extratemporal lobe seizure, 15.8% in temporal lobe seizure, 5.3% in localization undetermined partial seizure. Structural lesions in MRI were found in 51.6% with hippocampal atrophy being the most frequently round(59.4%). Focal encephalomalacia comprised 15.8%, focal atrophy in 4.8*/o. vascular malformation in 4.2%, granuloma in 3.7%, tumor in 3.7%, cyst in 2.4%. Patients with clinically judged temporal lobe seizure had the most common structural lesions in MRI. Which were seen in 59.2%. Extratemporal lobe seizure had focal lesion in 50.6%. Localization undetermined partial seizure in 50.5%, and generalized seizure in 23.1%. Among 98 patients with hippocampal atrophy, 27 patients(27.6%) had dual pathology with focal encephalomalacia being the most common. 11 patients(11.3%) were suspected to have bilateral hippocampal atrophy. Hippocampal atrophy was more commonly seen in patients with history of febrile convulsion and in patients with severe seizure. "