Original Research Paper
Hippocampal Magnetic Resonance Imaging In Focal Onset Seizure With Impaired Awareness -descriptive Study From Tertiary Care Centre In Southern Part Of India
Aleena Elizabeth Andrews, Naufal Perumpalath, Juvaina Puthiyakam, Andrews Ma
Temporal lobe epilepsy is the most common type of focal onset seizure. Focal onset seizure with impaired awareness ,previously known as complex partial seizure (CPS) ,account for 18 - 40% of all seizure types. Hippocampal sclerosis (HS)is the most common cause of temporal lobe epilepsy, which produce focal onset seizure with impaired awareness. It may be detected in MRI visually, but bilateral abnormalities are better identified using volumetric analysis.Aim: To assess hippocampus visually and volumetrically in Focal onset seizure with impaired awarenessSettings and Design: This cross-sectional study includes clinically diagnosed cases of focal onset seizure with impaired awareness undergoing MRI at Government Medical College Calicut. Methods and Materials: All the subjects (n=56) with clinical diagnosis of Focal onset seizure with impaired awareness were included in the study. (sample size required 42)Statistical analysis: Quantitative variables are reported as means+/SD and the qualitative variables as percentage. Students t test used to compare means and correlation coefficient to find relationship between duration of complex partial seizure and hippocampal volume. The values below 5% (p value < 0.05) were considered statistically significant.Results:Out of 53 patients studied, hippocampal atrophy was identified visually in 13(24.5%) on right side, 9 (16.98%) on left side and in 6(11.32%) bilaterally. However, with volumetry hippocampal atrophy (not taking T2 signal change) was detected in 15 (28.30 %) on right side ,10(18.86%) on left side and in 7(13.20 %) bilaterally. Hippocampal volumes between ipsilateral and contralateral seizure focus were found to have no significant difference (p-0.84). Conclusions:Visual analysis though efficient in the diagnosis of pathology, MR volumetry may be used as an expert eye in cases of subtle volume loss.
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