CC BY-NC-ND 4.0 · International Journal of Epilepsy 2021; 07(02): 070-078
DOI: 10.1055/s-0042-1744155
Original Article

Structural Brain Lesions in Epilepsy Patients: An Experience from Northeast India

Baiakmenlang Synmon
1   Department of Neurology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
Pranjal Phukan
2   Department of Radiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
Binoy K. Singh
3   Department of Neurosurgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
Musharraf Hussain
1   Department of Neurology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
Shri Ram Sharma
1   Department of Neurology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
Yasmeen Hynniewta
1   Department of Neurology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
› Author Affiliations
Funding None.


Objectives The aim of this article was to study the various structural causes and role of magnetic resonance imaging (MRI) in epilepsy patients.

Materials and Methods A 4-year retrospective cross-sectional study was conducted in Northeast India. The MRI brain findings of epilepsy patient were collected and analyzed for the years 2017 to 2020.

Result A total of 630 patients of epilepsy underwent MRI brain with normal findings noted in 280 patients (44.4%). The other groups of 350 epilepsy patients (55.5%) had abnormal MRI brain findings and were included in the study with a minimum age of 2-month old and a maximum of 80 years. The most common abnormal MRI finding belongs to the infectious group (33.7%), with neurocysticercosis being the most common infectious etiology (p-value < 0.001). Gliosis was seen in 57 patients (16.3%), mostly in the middle-aged group. Vascular etiology was seen in 44 patients (12.6%), mostly in the middle-aged group. Features of hypoxic brain injury was seen in 26 patients (7.4%), mostly among patients of <18 years age. Mesial temporal lobe epilepsy was seen in 45 patients (12.9%), mostly seen in the adolescent. Neuronal migration defect was seen in 23 patients (6.5%), mostly among adolescent and young adults. Other abnormal MRI findings were tumor in 8 patients (2.3%), diffuse gyral swelling in 11 patients (3.1%), Rasmussen encephalitis in 4 patients (1.1%), neurocutaneous syndrome in 4 patients (1.1%), radiation necrosis and cyst in 1 patient each, Dyke-Davidoff-Masson syndrome in 3 patients, moyamoya disease in 1 patient, posterior reversible encephalopathy syndrome in 2 patients, and vasculitis in 4 patients.

Conclusion MRI brain is the key investigation to identify the epileptic focus in epilepsy patients helping in their further treatment and prognosis.


This study was conducted in North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Publication History

Article published online:
08 March 2022

© 2022. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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