Role of neuroimaging in first seizure diagnosis.
The primary goal of neuroimaging in a first, unprovoked seizure is to identify a lesion that can explain the seizure. Secondarily, neuroimaging may be used to predict seizure recurrence and assist with the diagnosis of epilepsy. However, the events leading from a first seizure to epilepsy, with or without an identifiable epileptogenic lesion, are not well understood, and it is not always clear which lesions are epileptogenic as opposed to incidental. Much neuroimaging research to date has focused on findings in chronic epilepsy, rather than first seizure. Dedicated epilepsy imaging with high quality MRI protocols maximizes the likelihood of a diagnosis. However, a significant proportion of patients are MRI-negative, prompting researchers in the field to continue the search for better imaging strategies. Here we describe the role of neuroimaging in the assessment of a first seizure, the current state of the art and possible future directions.
Department of Diagnostic Radiology, Dalhousie University, Room 3388, Halifax Infirmary, 1796 Summer Street, Halifax, Nova Scotia B3H 3A7, Canada; Nova Scotia Early Psychosis Program, Department of Psychiatry, Dalhousie University, Rm 3030, Abbie J Lane Building, 5909 Veterans' Memorial Lane, Halifax, Nova Scotia B3H 2E2, Canada. Electronic address: Candice.Crocker@dal.ca.
Candice E
CE
Crocker
Division of Neurology, Department of Medicine, Dalhousie University, Room No 3838, Halifax Infirmary, 1796 Summer Street, Halifax, Nova Scotia B3H 3A7, Canada.
Bernhard
B
Pohlmann-Eden
Department of Diagnostic Radiology, Dalhousie University, Room 3388, Halifax Infirmary, 1796 Summer Street, Halifax, Nova Scotia B3H 3A7, Canada.
Matthias H
MH
Schmidt
D001921:Brain / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging; D012640:Seizures / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
DTI; Epilepsy; First seizure; MRI; PET