頭部 CT上 滴疾性 病所의 消失에 대한 臨床的 意義

Clinical significance of Resolved Epileptic Foci on Follow-up CT

Computed tomography of the brain (CT) has been used routinely, as well as the EEG, to study patients with epilepsy. It gives accurate information about the nature, size, topography and location of morphological abnormalities, and moreover helps to make therapeutic plan of epileptics because CT has made it possible to follow the evolution of epileptic foci. This study was designed to investigate the clinical significance of resolved epileptic foci on follow- up CT. The subjects were the patients who revealed focal low density on CT among the epileptics who visited Kyung Hee University Hospital from the period of March, 1980 to February, 1983. The number of the subjects studied was 24 cases of 15 males and 9 females. The followings were the main results of the study. 1. Male to female ratio was 1. 7 to 1. Age dist-ribution revealed to be heavily concentrated in under the age of 30 (17cases, 70.8%). 2. All cases revealed focal low density with or without enhancement on CT. The most common site of lesion was parietal cortex. 3. Nearly complete disappearance or resolution of the focal low density lesion was revealed on follow-up CT in all the subjects. 4. Nim cases improved on the follow-up EEG were consistent with the follow-up CT findings. 5. Operation was performed in 1 case. The biopsy revealed gliosis and perivascular mononuclear cell infiltration, that is nonspecific inflammatory findings such as virus. 6. Considering the age of onset, clinical course and symptomatology, it was supposed that focal low density on CT was focal cerebritis due to virus. 7. The authors propose cautiously that anticonvulsant withdrawal can be attempted through close observation and follow-up study in the cases showing the complete resolution of lesions on followup CT and EEG.