Morphometric magnetic resonance imaging (MRI) postprocessing in MRI-negative patients with first unprovoked seizure

被引：3

作者：

Tsalouchidou, Panagiota-Eleni ^{[1
,2
,6
]}

Hoffmann, Johanna ^{[1
]}

Strehlau, Sascha ^{[1
]}

Linka, Louise ^{[1
]}

Belke, Marcus ^{[1
,3
]}

Habermehl, Lena ^{[1
]}

Schulze, Maximilian ^{[4
]}

Kemmling, Andre ^{[4
]}

Menzler, Katja ^{[1
,3
,5
]}

Knake, Susanne ^{[1
,3
,5
]}

机构：

[1] Philipps Univ Marburg, Epilepsy Ctr Hessen, Dept Neurol, Marburg, Germany

[2] Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Dept Neurol 2, Athens, Greece

[3] Philipps Univ Marburg, Ctr Mind Brain & Behav CMBB, Marburg, Germany

[4] Philipps Univ Marburg, Dept Neuroradiol, Marburg, Germany

[5] Univ Marburg, Fac Med, Core Facil BrainImaging, Marburg, Germany

[6] Philipps Univ Marburg, Epilepsy Ctr Hessen, Dept Neurol, Baldingerstr, D-35043 Marburg, Germany

来源：

EPILEPSIA | 2024年 / 65卷 / 04期

关键词：

first epileptic seizure; focal cortical dysplasia; lesional epilepsy; MRI postprocessing; MRI-negative epilepsy; FOCAL CORTICAL DYSPLASIA; RISK;

D O I：

10.1111/epi.17909

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

ObjectiveThe aim of the study was to evaluate the benefits of morphometric magnetic resonance imaging (MRI) postprocessing in patients presenting with a first seizure and negative MRI results and to investigate these findings in the context of the clinical and electroencephalographic data, seizure recurrence rates, and epilepsy diagnosis in these patients. MethodsWe retrospectively reviewed 97 MRI scans of patients with first unprovoked epileptic seizure and no evidence of epileptogenic lesion on clinical routine MRI. Morphometric Analysis Program (MAP; v2018), automated postprocessing software, was used to identify subtle, potentially epileptogenic lesions in the three-dimensional T1-weighted MRI data. The resulting probability maps were examined together with the conventional MRI images by a reviewer who remained blinded to the patients' clinical and electroencephalographical data. Clinical data were prospectively collected between February 2018 and May 2023. ResultsAmong the apparently MRI-negative patients, a total of 18 of 97 (18.6%) showed cortical changes suggestive of focal cortical dysplasia. Within the population with positive MAP findings (MAP+), seizure recurrence rates were 61.1% and 66.7% at 1 and 2 years after the first unprovoked seizure, respectively. Conversely, patients with negative MAP findings (MAP-) had lower seizure recurrence rates of 27.8% and 34.2% at 1 and 2 years after the first unprovoked seizure, respectively. Patients with MAP+ findings were significantly more likely to be diagnosed with epilepsy than those patients with MAP- findings (chi(2) [1, n = 97] = 14.820, p < .001, odds ratio = 21.371, 95% CI = 2.710-168.531) during a mean follow-up time of 22.51 months (SD = 16.7 months, range = 1-61 months). SignificanceMRI postprocessing can be a valuable tool for detecting subtle epileptogenic lesions in patients with a first seizure and negative MRI results. Patients with first seizure and MAP+ findings had high seizure recurrence rates, meeting the criteria for beginning epilepsy.

引用

页码：1107 / 1114

页数：8

共 18 条

[11] Evidence-Based Guideline: Management of an Unprovoked First Seizure in Adults Report of the Guideline Development Subcommittee of the American Academy of Neurology and the American Epilepsy Society [J].