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E1560. Seizing the List: A Case-Based Review of Epileptogenic Lesions
Authors
  1. Shreya Patel; NewYork-Presbyterian/Columbia University Medical Center
  2. Gul Moonis; NewYork-Presbyterian/Columbia University Medical Center
Background
The workup of patients with epilepsy requires a multifaceted approach where magnetic resonance imaging (MRI) is used in conjunction with clinical evaluation and electroencephalogram (EEG) to determine the diagnosis and guide the appropriate therapy. Neuroimaging plays a key role in identifying culprit epileptogenic lesions, especially in patients with partial seizures refractory to medical management. The purpose of this educational exhibit is to familiarize the reader with the spectrum of imaging findings seen in epileptogenic lesions.

Educational Goals / Teaching Points
This exhibit will familiarize the reader with MR imaging protocols and techniques used for evaluating seizures, review hippocampal anatomy, and cover imaging findings and relevant clinical features of common and uncommon epileptogenic lesions via a case-based approach.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
1. MRI imaging techniques and seizure imaging protocols 2. Hippocampal anatomy 3. Cases of epileptogenic lesions: mesial temporal sclerosis, malformations of cortical development (polymicrogyria, gray matter heterotopia, schizencephaly, focal cortical dysplasia), epilepsy associated neoplasms (ganglioglioma, dysembryoplastic neuroepithelial tumor (DNET), pleomorphic xanthoastrocytoma, hypothalamic hamartoma), vascular malformations (cavernous malformations, arteriovenous malformation), congenital neurocutaneous syndrome (Sturge-Weber syndrome, tuberous sclerosis), infectious/inflammatory (viral/bacterial/fungal/autoimmune), and Rasmussen’s encephalitis 4. Cases demonstrating pitfalls in seizure imaging including anatomic variants

Conclusion
After the reader has viewed the case-based exhibit, they will be able to recognize both common and uncommon lesions that can cause epilepsy in the adult and pediatric population.