Skip to main content
SpringerLink
Log in

14 Neuroimaging of Seizures

  • Chapter
  • First Online:
Evidence-Based Imaging

  • 1154 Accesses

Key Points

The main goal of neuroimaging in seizures is to rule out focal lesions that could threaten the patient’s life (i.e., neoplasm or other intracranial space-occupying lesion). The most important role of neuroimaging in epilepsy is to identify the structural substrate of the epileptogenic focus. Neuroimaging is not recommended for a simple febrile seizure ­(limited evidence). Computed tomography scan is the best imaging study in the evaluation of patients with acute nonfebrile symptomatic seizures because it detects important abnormalities, such as acute intracranial hemorrhage, that may require immediate medical or surgical treatment (limited evidence). Magnetic resonance imaging (MRI) is the neuroimaging study of choice in the workup of first unprovoked seizures (moderate evidence). Focal neurologic deficit is an important predictor of an abnormality in the neuroimaging examination (moderate evidence). Magnetic resonance (MR) evaluation should be performed in nonacute symptomatic seizure patients with confusion and postictal deficits (moderate evidence). MR should be performed in children with unexpected cognitive or motor delays or children under 1 year of age, with remote symptomatic seizures (moderate evidence). Patients with focal seizures, abnormal EEG, or generalized epilepsy should be imaged (moderate evidence). MRI is the imaging modality of choice in temporal lobe epilepsy (moderate evidence). Ictal single photon emission computed tomography (SPECT) is the best neuroimaging examination to localize seizure activity (moderate evidence).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 1989;34:592–596.

    Google Scholar 

  2. Bell GS, Sander JW. Seizure 2001;10:306–316.

    Article  PubMed  CAS  Google Scholar 

  3. Senanayake N, Roman GC. Bull WHO 1993;71:247–225.

    PubMed  CAS  Google Scholar 

  4. Hauser WA, Annegers JF, Kurland LT. Epilepsia 1993;34:453–468.

    Article  PubMed  CAS  Google Scholar 

  5. Lavados J, Germain L, Morales A et al. Acta Neurol Scand 1992;85:249–256.

    Article  PubMed  CAS  Google Scholar 

  6. Rwiza HT, Kilonzo GP, Haule J et al. Epilepsia 1992;33:1051–1056.

    Article  PubMed  CAS  Google Scholar 

  7. Hauser WA, Annegers JF, Rocca WA. Mayo Clin Proc 1996;71:576–586.

    Article  PubMed  CAS  Google Scholar 

  8. Berg AT, Shinnar S, Hauser WA et al. J Pediatr 1990;116:329–337.

    Article  PubMed  CAS  Google Scholar 

  9. Knudsen FU. Arch Dis Child 1985;60:1045–1049.

    Article  PubMed  CAS  Google Scholar 

  10. Offringa M, Bossuyt PMM, Lubsen J et al. J Pediatr 1994;124:574–584.

    Article  PubMed  CAS  Google Scholar 

  11. Annegers JF, Shirts SB, Hauser WA et al. Epilepsia 1986;27:43–50.

    Article  PubMed  CAS  Google Scholar 

  12. Berg AT, Shinnar S. Neurology 1996;47:562–568.

    PubMed  CAS  Google Scholar 

  13. Berg AT, Shinnar S. Neurology 1991;41:965–972.

    PubMed  CAS  Google Scholar 

  14. Shorvon SD. Epilepsia 1996;37(suppl 2):S1–S3.

    Article  PubMed  Google Scholar 

  15. Murray MI, Halpern MT, Leppik IE. Epilepsy Res 1996;23:139–148.

    Article  PubMed  CAS  Google Scholar 

  16. Ho SS, Kuzniecky RI. J Neuroimaging 1997;7:236–241.

    PubMed  CAS  Google Scholar 

  17. De Zelicourt M, Buteau L, Fagnani F et al. Seizure 2000;9:88–95.

    Article  PubMed  Google Scholar 

  18. Bronen RA, Fulbright RK, Spencer SS et al. Magn Reson Imaging 1997;15:857–862.

    Article  PubMed  CAS  Google Scholar 

  19. Offringa M, Moyer VA. West J Med 2001;175:254–259.

    Article  PubMed  CAS  Google Scholar 

  20. American Academy of Pediatrics Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures. Pediatrics 1996;97:769–772; discussion 773–775.

    Google Scholar 

  21. Eisner RF, Turnbull TL, Howes DS et al. Ann Emerg Med 1986;15:33–39.

    Article  PubMed  CAS  Google Scholar 

  22. Earnest MP, Feldman H, Marx JA et al. Neurology 1988;38:1561–1565.

    PubMed  CAS  Google Scholar 

  23. Reinus WR, Wippold FJ 2nd, Erickson KK. Ann Emerg Med 1993;22:1298–1303.

    Article  PubMed  CAS  Google Scholar 

  24. Henneman PL, DeRoos F, Lewis RJ. Ann Emerg Med 1994;24:1108–1114.

    Article  PubMed  CAS  Google Scholar 

  25. Bradford JC, Kyriakedes CG. Emerg Med Clin North Am 1999;17:203–220.

    Article  PubMed  CAS  Google Scholar 

  26. Shinnar S, O’Dell C, Mitnick R et al. Epilepsy Res 2001;43:261–269.

    Article  PubMed  CAS  Google Scholar 

  27. King MA, Newton MR, Jackson GD et al. Lancet 1998;352:1007–1011; comments 1855–1857.

    Article  PubMed  CAS  Google Scholar 

  28. Hirtz D, Ashwal S, Berg A et al. Neurology 2000;55:616–623.

    PubMed  CAS  Google Scholar 

  29. Maytal J, Krauss JM, Novak G et al. Epilepsia 2000;41:950–954.

    Article  PubMed  CAS  Google Scholar 

  30. Hopkins A, Garman A, Clarke C. Lancet 1988;1:721–726.

    Article  PubMed  CAS  Google Scholar 

  31. Schoenenberger RA, Heim SM. Br Med J 1994;309:986–989.

    CAS  Google Scholar 

  32. Garvey MA, Gaillard WD, Rusin JA et al. J Pediatr 1998;133:664–669.

    Article  PubMed  CAS  Google Scholar 

  33. Harvey AS, Berkovic SF, Wrennall JA et al. Neurology 1997;49:960–968.

    PubMed  CAS  Google Scholar 

  34. Kramer U, Nevo Y, Reider-Groswasser I et al. Seizure 1998;7:115–118.

    PubMed  CAS  Google Scholar 

  35. Berg A, Testa FM, Levy SR et al. Pediatrics 2000;106:527–532.

    Article  PubMed  CAS  Google Scholar 

  36. Lee DH, Gao F-Q, Rogers JM et al. AJNR Am J Neuroradiol 1998;19:19–27.

    PubMed  CAS  Google Scholar 

  37. Sinclair DB, Wheatley M, Aronyk K et al. Pediatr Neurosurg 2001;35:239–246.

    Article  PubMed  CAS  Google Scholar 

  38. Spencer SS. Epilepsia 1994;35(suppl):S72–S89.

    Article  PubMed  Google Scholar 

  39. Moore KR, Swallow CE, Tsuruda JS. AJNR Am J Neuroradiol 1999;20:1609–1612.

    PubMed  CAS  Google Scholar 

  40. Jack CR Jr, Sharbrough FW, Twomey CK et al. Radiology 1990;175:423–429.

    PubMed  Google Scholar 

  41. Watson C, Cendes F, Fuerst D et al. Arch Neurol 1997;54:67–73.

    PubMed  CAS  Google Scholar 

  42. Oppenheim C, Dormont D, Biondi A et al. AJNR Am J Neuroradiol 1998;19:457–463.

    PubMed  CAS  Google Scholar 

  43. Jack CR Jr, Rydberg CH, Krecke KN et al. Radiology 1996;1996:367–373.

    Google Scholar 

  44. Berkovic SF, McIntosh AM, Kalnins RM et al. Neurology 1995;45:1358–1363.

    PubMed  CAS  Google Scholar 

  45. Devous MD Sr, Thisted RA, Morgan GF et al. J Nucl Med 1998;39:285–293.

    PubMed  Google Scholar 

  46. Newton MR, Berkovic SF, Austin MC et al. J Neurol Neurosurg Psychiatry 1995;59:26–30.

    Article  PubMed  CAS  Google Scholar 

  47. Lewis PJ, Siegel A, Siegel AM et al. J Nucl Med 2000;41:1619–1626.

    PubMed  CAS  Google Scholar 

  48. Park S-W, Chang K-H, Kim H-D et al. AJNR Am J Neuroradiol 2001;22:625–631.

    PubMed  CAS  Google Scholar 

  49. Woermann FG, Jokeit H, Luerding R et al. Neurology 2003;61:699–701.

    PubMed  CAS  Google Scholar 

  50. Gaillard WD, Balsamo L, Xu B et al. Neurology 2002;59:256–265.

    PubMed  CAS  Google Scholar 

  51. Medina LS, Bernal B, Dunoyer C et al. Radiology 2005;236:247–253.

    Article  PubMed  Google Scholar 

  52. Medina LS, Aguirre E, Bernal B, Altman NR. Radiology 2004;230:49–54.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Miami Children’s Hospital, 3100 SW 62 Avenue, Miami, FL, 33176, USA

    Byron Bernal

Authors
  1. Byron Bernal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nolan Altman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Byron Bernal .

Editor information

Editors and Affiliations

  1. , Department of Radiology, Miami Children's Hospital, SW 114 Street 7420, Miami, 33156, Florida, USA

    L. Santiago Medina

  2. Harborview Medical Center, Department of Radiology, University of Washington, Ninth Avenue 325, Seattle, 98104-2499, Washington, USA

    C. Craig Blackmore

  3. , Department of Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, 30322, USA

    Kimberly Applegate

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer New York

About this chapter

Cite this chapter

Bernal, B., Altman, N. (2011). 14 Neuroimaging of Seizures. In: Medina, L., Blackmore, C., Applegate, K. (eds) Evidence-Based Imaging. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7777-9_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-7777-9_14

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-7776-2

  • Online ISBN: 978-1-4419-7777-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation