Structural Brain Lesion in Epilepsy Patients: An Experience from Northeast India

Objectives The aim of this article is to study the various structural causes and role of magnetic resonance imaging (MRI) in epilepsy patients. Materials and Methods A 4-year retrospective cross-sectional study was conducted in Northeast India. The MRI brain findings of epilepsy patient were collected and analyzed for the years 2017 to 2020. Result A total of 630 patients of epilepsy underwent MRI brain with normal findings noted in 280 patients (44.4%). The other groups of 350 epilepsy patients (55.5%) had abnormal MRI brain findings and were included in the study with a minimum age of 2-month old and a maximum of 80 years. The most common abnormal MRI finding belongs to the infectious group (33.7%), with neurocysticercosis being the most common infectious etiology (p-value < 0.001). Gliosis was seen in 57 patients (16.3%), mostly in the middle-aged group. Vascular etiology was seen in 44 patients (12.6%), mostly in the middle-aged group. Features of hypoxic brain injury was seen in 26 patients (7.4%), mostly among patients of <18 years age. Mesial temporal lobe epilepsy was seen in 45 patients (12.9%), mostly seen in the adolescent. Neuronal migration defect was seen in 23 patients (6.5%), mostly among adolescent and young adults. Other abnormal MRI findings were tumor in 8 patients (2.3%), diffuse gyral swelling in 11 patients (3.1%), Rasmussen encephalitis in 4 patients (1.1%), neurocutaneous syndrome in 4 patients (1.1%), radiation necrosis and cyst in 1 patient each, Dyke-Davidoff-Masson syndrome in 3 patients, moyamoya disease in 1 patient, posterior reversible encephalopathy syndrome in 2 patients, and vasculitis in 4 patients. Conclusion MRI brain is the key investigation to identify the epileptic focus in epilepsy patients helping in their further treatment and prognosis.