LETTER RE: Neuroimaging of first-ever seizure: Contribution of MRI if CT is normal

We read an excellent study pertaining to neuroimaging in first-ever seizure by Kevin Ho et al.¹ In the era of modern imaging, CT and MRI are the modalities of choice along with EEG. Imaging helps rule out structural lesions, which at times require medical treatment, e.g. tuberculoma and neurocysticercosis in addition to seizures. Some of these patients also require surgical excision like neoplasms and various surgical procedures for prevention of seizures. Here the MRI definitely will be superior to CT as the authors have observed in their study. MRI studies have elucidated the various congenital abnormalities like heterotopias that ultimately may require surgery. MRI should be modality of choice if it is available except when patient or other technical problems do not permit it. Furthermore patients with focal onset seizures not easily controlled on antiepileptic drugs should undergo MRI. Repeated CT for follow up also adds to radiation hazards.

Disclosures: The authors report no disclosures.

Reference

1. Ho K, Lawn N, Bynevelt M, Lee J, Dunne, J. Neuroimaging of first-ever seizure: contribution of MRI if CT is normal. Neurol Clin Pract 2013;3:398-403.