Neuroimaging in Elderly with New-Onset Unprovoked Seizures - A Pictorial Review
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 9
Abstract
An unprovoked seizure in elderly is a common occurrence. Various causes of seizures in these patients include cerebrovascular accidents, neurodegenerative disorders like Alzheimer's disease, intracranial tumours and post traumatic epilepsy. The morbidity associated with seizures is likely to be more in elderly patients and they may suffer significant injuries like vertebral and hip fractures or shoulder dislocations. Moreover they usually have a prolonged postictal phase. The imaging is one of the important aspects of management of these patients. CT scan and MRI are the most common imaging modalities for this purpose in these patients. Our study comprised of 52 elderly patients with unprovoked seizures. Neuroimaging of these patients revealed that in most of the patients (50%) CT scan was normal while the common CT findings in these patients were found to be age related cerebral atrophy (21.43%), Gliosis (12.5%) and infarcts (7.14%). MRI was done in 28 patients in whom CT brain was either equivocal or when the lesion needed further evaluation. 28 such patients underwent MRI scans. MRI was normal in 8 (14.29%) patients. The common MRI abnormalities found in these patients included cortical atrophy (10.71%), infarcts (10.71%), small vessel disease (7.14%) and white matter abnormalities (3.57%). MRI was found to be more accurate in the diagnosis of infarct as it was able to demonstrate infracts in some of the patients in whom CT was reported to be normal. Neuroimaging observations in elderly patients with new-onset unprovoked seizures revealed many underlying abnormalities. In some cases it was reassuring to have normal neuroimaging while in others neuroimaging abnormalities assisted in deciding appropriate therapy.
Authors and Affiliations
S. Elangovan, M. Thangaraj, k Balamurali, M. Arun Kumar
Keywords
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