1. Jalal Jalal Shokouhi – MD Editor in Chief of Iranian Society of Radiology jalaljalalshokouhi@hotmail/gmail.comjalaljalalshokouhi@hotmail/gmail.com www.medimage.ir www.medimage.ir jalaljalalshokouhi@hotmail/gmail.comwww.medimage.ir Imaging of epilepsis

2. Seizure is the clinical manifestations of an abnormal and excessive excitation of a population of neurons in the brain. Epilepsy is recurrent on provoked seizures.

3. Etiology of seizures and epilepsy is idiopathic cryptogenic in 65.5%, Vascular 10.9%, congenital 8%, Traumatic 5.5%, neoplastic 4.1%, degenerative 3.5%, and infectious 2.5% (hauser wa,et al).

4. Risk factors for epilepsy that imaging can show them, are: Head injuries in military and civilian populations, Stroke, Embolic risk factors, left ventricular hypertrophy, Encephalitis, Bacterial meningitis, Aseptic meningitis, Alzheimer disease, multiple sclerosis, Alcohol, Heroin and Marijuana intoxication.

5. For treatment control, also also imaging could be in plan.

6. Conclusion: Although EEG is the most specific test for diagnosis but MRI is the imaging tool of choice, especially in partial epilepsy.

7. PET, SPECT, MEG are important for localization of seizure focus often used in pre-surgical evaluations.

8. Epilepsy diagnosis  Clinic  EEG, Brain mapping  CT, CTA  MRI, MRA, MRV  Magnetography  Mulecular, Spect, Pet

9. CT and MRI in Epilepsy

10. Pathology and causes: 1.Developmental disorders Neuronal migration disorders Hamartomas Vascular malformations,… Neuronal migration disorders include the following: 1.Tuberous sclerosis 2.Focal cortical dysplasias 3.Polymicrogyria 4.Schizencephaly 5.Heterotopias 6.Lissencephaly (agyria-pachygria) 7.Hemimegalencephaly 8.Microdysgenesis

11. GREY MATTER HETEROTOPIA, BAND HETEROTOPIA, NODULAR SUBEPANDIMAL

12. VASCULAR ANOMALY, PARIETAL TEMPORAL AND OCCIPITAL

13. ENHANCED VASCULAR ANOMALYBILATERAL SCHIZENCEPHALIC CLEFTS CLEFT IN SAGITAL

14.  2.Traumatic Hematomas, foreign bodies, penetrating injuries, depressed fractures, brain edema, …Hematomas, foreign bodies, penetrating injuries, depressed fractures, brain edema, …  3.Vascular, hemorrhagic and ischemic Cerebrovascular disease, including stroke, porencephaly, …Cerebrovascular disease, including stroke, porencephaly, …

15. SITES OF TRAUMATIC LESIONS

16. HEMATOMAS

17. ANEURYSM

18. ANEURYSMS

19. VASCULAR ANOMALY

21. ISCHEMIC & HEMORRHAGIC

22. VASCULAR ANOMALY

23. ISCHEMIC CHANGES

24. 4.Neoplasms GliomasGliomas Mixed neuronoglial tumorsMixed neuronoglial tumors Dysembryoplastic neuroepithelial tumorDysembryoplastic neuroepithelial tumor OthersOthers5.Infections Infections (bacterial, viral, fungal, parasitic diseases) &Infections (bacterial, viral, fungal, parasitic diseases) & Immune-mediated disorders (Rasmussen`s syndrome)Immune-mediated disorders (Rasmussen`s syndrome) 6.Mesial temporal sclerosis(hippocampus)

25. SPECT, HYPER PERFUSION 12 SECONDS AFTER EPILEPSIES, TRACER WAS INJECTED

26. HIPPOCAMPAL ATROPHY, MESIAL TEMPORAL SCLEROSIS

27. ASTROCYTOMA IN THE RIGHT MESIAL TEMPORAL LOBE COVERNOUS HEMANGIOMA IN THE RIGHT MESIAL TEMPORAL LOBE

28. DURAL BASED MENINGIOMA WITH CALCIFICATION

29. Cysticercosis+hydatid

30. A NEOPLASM

31. ANOTHER NEOPLASM WITH SEVERE EDEMA AND MIDLINE SHIFT

32. A HUGE SIZED NEOPLASM WITH BILATERAL EDEMA

33. HIPPOCAMPUS MESIAL TEMPORAL SCLEROSIS

34. LEFT FRONTAL AND TEMPORAL HYPOMETABOLISM IN A: TEMPORAL LOBE EPILEPSY PET. CRONAL SPECT- HMPAO SCAN SHOWING: INCREASED PERFUSION IN THE LEFT FRONTAL LOBE IN RASMUSSEN`S ENCEPHALITIS+ HYPERPERFUSION IN AXIAL Axial Coro

35. Epilepsy induced by atrophy