Cerebral magnetic resonance as a diagnostic tool in epileptic syndromes

Searching for cerebral lesions associated with juvenile or adult onset epilepsy is mandatory in order to identify a possible surgical treatment. Since the introduction of CT, more information on the pathology of epilepsies has been obtained. Magnetic resonance (MR) has been shown to be more sensitive than CT in the study of brain lesions. We examined by MR 121 epileptic patients, pharmacologically well controlled and with a previous normal CT. MR revealed borderline or aspecific brain abnormalities in 10% of all epileptics (more often with partial epilepsies). MR revealed unsuspected focal brain lesions in 23% of patients with focal epilepsies. MR and CT were both normal in 96% and 80%, respectively, of patients with primary or secondary generalized epilepsies. We conclude that MR is the imaging technique of first choice for patients with focal epilepsies, but not for those with generalized epilepsies.