Abstract Details

Title Comparing CECT with NCCT in drug-responsive focal epilepsy- A prospective observational study

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-002

Objective

To compare NCCT with CECT in evaluating drug-responsive focal epilepsy.

Background Being more sensitive than CT for picking up surgically amenable lesions, brain MRI is imaging gold standard for focal epilepsy (FE). However, many FE patients respond to medical treatment alone. Additionally, in many LMICs, FE often results from calcified lesions best picked up on CT. While a CT may be enough for imaging many FE patients, it is unclear how many lesions may be missed if the CT is non-contrast-enhanced.

Design/Methods Consecutive patients with focal or unknown onset epilepsy, ≥ 12 years old, unlikely to require epilepsy surgery, were recruited in this prospective observational study. All patients underwent brain NCCT and CECT that were reported independently by three neuroradiologists.

Results

Between October 2017 and August 2019, 223 patients with focal onset (87%) or unknown onset (13%) epilepsy fulfilling inclusion criteria were recruited. The mean age was 25.8±10 years. Majority (92%) had epilepsy for ≥three months and an annual seizure frequency between 2-10. There was a good inter-observer agreement between 3 neuroradiologists reporting the NCCT and CECT as normal or abnormal (kappa- 0.928 and 1.0, respectively). There was no significant difference in the proportion of NCCTs and CECTs reported abnormal (50.7% vs. 51.6%, p=0.91). Solitary calcified granuloma was the most common abnormality reported on NCCT as well as CECT (21.1% and 19.3%, respectively). CECT made a significant change in radiological diagnosis in only four patients (1.8%). Additional findings on CECT did not change management in any patient.

Conclusions

There was no significant difference in NCCT and CECT findings in FE patients. NCCT may suffice as an imaging modality in patients who are not surgical candidates.

Authors/Disclosures
Jasmine Parihar, DM (All India Institute of Medical Sciences, New Delhi.) PRESENTER	Dr. Parihar has nothing to disclose.
Mamta B. Singh, MD, MBBS, DM, FAAN (All India Institute of Medical Sciences)	Dr. Singh has nothing to disclose.
Ajay Garg	Ajay Garg has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Padma V. Hadakasira, MD (Medwis Healthcare Communications Pvt Ltd)	Dr. Hadakasira has nothing to disclose.
Vinay Goyal Goyal, MD, DM, FIAN (Director Neurology)	Prof. Goyal has nothing to disclose.
	No disclosure on file
Shailesh Gaikwad	Shailesh Gaikwad has nothing to disclose.
Garima Shukla, MD, MBBS, DM, FRCPC (Queen's University and Kingston Health Sciences Centre,)	The institution of Prof. Shukla has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier.

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