Structural findings in brain MRI of patients who attended the CMDLT imaging service with a history of Epilepsy in the period 2020-2025.

Abstract

Cerebral Magnetic Resonance Imaging (MRI) is the most sensitive and versatile neuroimaging technique for identifying the underlying structural abnormalities that trigger epilepsy, making it essential in patients with seizures of unknown origin or recurrent and refractory forms. The objective of this study was to evaluate the different structural findings present on cerebral MRIs of patients with a history of epilepsy who attended the CMDLT imaging service between 2020 and 2025. We confirm that the appropriate detection of these lesions requires the application of a specific and optimized acquisition protocol, such as the HARNESS-MRI, which includes key sequences like T1 TFE 3D, T2 FLAIR 3D, and T2 SE 2D, to ensure the necessary high spatial and contrast resolution. The results obtained in our study population were consistent with international literature, identifying Anomalies of Cortical Development (ACD)—especially Focal Cortical Dysplasia (FCD)—and Mesial Temporal Sclerosis (MTS) as the most common structural findings, in addition to the probable coexistence between these or other pathologies. In conclusion, the rigorous implementation of high-resolution MRI protocols is fundamental for Imaging and Neurology, as the precise detection of these lesions guides diagnostic and therapeutic management, including evaluation for epilepsy surgery, thus optimizing the patient's prognosis.