Routine MR imaging is widely used to evaluate various primary brain diseases that cause seizures. These include stroke, anoxic injury, trauma, tumor, infections, demyelination, congenital anomaly and many others. The typical MR finding in a seizure patient is an area of T2 hyperintensity, often located in the cerebral cortex, subcortical white matter, hippocampus, thalamus and/or cerebellum. DW imaging can provide additional information concerning the brain edema and tell whether it is primarily cytotoxic or vasogenic. This is important since cytotoxic edema following seizures indicates a more serious injury and, although often reversible, may result in brain atrophy and necrosis.

Figure 8.8 a-e

Focal lesion in the splenium of the corpus callosum in epilepsy in a 9-year-old presenting with intractable partial seizures since the age of 4 years.a Coronal T2-weighted and b FLAIR images 3 days after seizure show a focal hyperintense lesion in the central portion of the splenium of the corpus callosum (arrow). c Coronal DW image shows this lesion (arrow) as hyperintense associated with decreased ADC (d). e Gadolinium-enhanced Tl-weighted image reveals mild hypointense lesion with no abnormal enhancement (arrow)

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