Abstract

Seizures and epilepsy constitute one of the most prevalent neurological disorders encountered in clinical practice, affecting approximately 50 million individuals globally and representing a significant cause of neurological morbidity across all age groups. The clinical management of patients presenting with new-onset seizures requires accurate characterization of the underlying etiology, since the identification of a structural or pathological substrate guides treatment planning, surgical candidacy assessment, and prognostic counseling. Among the neuroimaging modalities available for seizure evaluation, magnetic resonance imaging at 1.5 Tesla has emerged as the superior investigation of choice, offering unparalleled soft tissue contrast, multiplanar capability, and sensitivity for detecting subtle cortical, subcortical, and infratentorial lesions that may be occult on computed tomography. The present prospective study was conducted at a single tertiary institution and enrolled 100 consecutive patients presenting with seizures who underwent 1.5 Tesla MRI brain examination, with the aim of characterizing the spectrum of neuroimaging findings and correlating MRI diagnoses with clinical seizure types and patient demographics. A male predominance was observed in the study population, and generalized tonic-clonic seizures constituted the most frequent clinical seizure type, accounting for 80 percent of all cases. MRI identified pathological findings in 65 of 100 patients (65 percent), with the principal diagnoses comprising infective granuloma including neurocysticercosis and tuberculoma in 17 percent of cases, cerebral infarction with gliosis in 16 percent, glioma in 9 percent, meningioma in 3 percent, developmental malformations in 2 percent, and venous sinus thrombosis among the miscellaneous group accounting for 17 percent collectively. These findings affirm MRI as the investigation of choice for seizure disorder evaluation, capable of detecting a broad spectrum of structural and pathological abnormalities with implications for patient management.