The Diagnostic Value of MRI Brain Epilepsy Protocol in Evaluation of Adults with Seizures

Background and objectives: The advent of high-resolution MRI with a dedicated epilepsy protocol improves the ability to identify possible structural abnormalities that underlie seizure disorders. The aims of this study were to evaluate the diagnostic efficacy of standard MRI, identify whether there is an increase in the diagnostic yield with the addition of dedicated seizure protocol, and compare the diagnostic yields of MRI and electroencephalogram (EEG) individually and in combination. Subjects and Methods: This was a cross-sectional analytic study, included 100 cases who presented with seizure over 18 months. Patients underwent complete neurological examination, EEG, and MRI with a standard and dedicated epilepsy protocol. Results: We found epileptogenic lesions in MRI in 55.5. Mesial temporal lobe sclerosis was the most common epileptogenic lesion (45.5%). The diagnostic efficacy of MRI had increased with dedicated epilepsy protocol compared to standard protocol. Abnormal MRI and EEG were compatible in 21%. Conclusion and implications: Dedicated epilepsy protocol increased the diagnostic efficacy of brain MRI in detecting a structural epileptogenic lesion, with 100% of mesial temporal sclerosis, the most common lesion in our study, was detected only in dedicated epilepsy protocol and missed in standard protocol.

The relationship of the temporomandibular joint disc thickness with facial growth according to Jarabak in adult male subjects (cephalometric and MRI study).

Mandible articulates with the cranium via the TMJ. All the components of the TMJ, including the TMJ disc, seem to be associated with altered characteristics of the craniofacial complex and its growth. However, the exact role of the TMJ disc thickness during the process of the facial growth is not clear yet. Aim: The aim of this study is to investigate the association between the TMJ disc thickness and the facial growth determined according to Jarabak in adult male subjects with no clinical or MRI symptoms of Temporomandibular Joint Disorders.

Analytical Study of Supratentorial Meningioma

This study included 96 meningiomas treated between the years of 1999 and 2003 . The age of patients was between 18-80 years ,with a mean age of 49.16 years. Females constituted 65.6% of the patients ,while males constituted 34.4%. Large percent of cases was between 4th to 6th decade of age, ( 56, 2% of all patients). Signs of raised intracranial pressure dominated the clinical picture presenting in 62% of patients, while epilepsy was the only symptom in 15% of the patients . MRI was performed in 81% of patients. The other patients were diagnosed by CT scan. Tumors were hemispheral in 74% of patients. The operating microscope and ultrasonic aspirator were used in 85% of cases.15% of tumors were removed using the classical methods, Total removal was achieved in 90% of cases. Clinical improvement was seen in 60.45 of cases while deterioration was seen in only 5.2% of cases. Complications included cerebral edema in five patients, and tumor recurrence in 5.2% of cases. Tumors were benign in 88%.Mortality was 2%.