Evaluating the Role of MRI in Uncovering Etiologies of New Onset Seizures in Adult: A Prospective Study from Tertiary Care Hospital
DOI:
https://doi.org/10.65761/pjcr.2026.282Keywords:
New onset Seizures, magnetic resonance imaging, adult epilepsy, neuroimaging, stroke, infectious etiologies neoplastic lesions.Abstract
Background: New-onset seizures in adults are a common neurological emergency, and Magnetic Resonance Imaging (MRI) is crucial in determining their etiology.
Methods: This descriptive cross-sectional analysis was performed at the Dow Institute of Radiology, DUHS, Karachi, between January and June 2025, and involved 279 adult patients aged 18–65 years who had first-time seizures. Standardized seizure-protocol brain MRI was performed on all patients and reviewed independently by two consultant radiologists. The results were collected and analysed descriptively and with chi-square statistics in SPSS-25 for age, gender, seizure type and MRI-detected aetiologies.
Results: The mean age was 41.0 ± 11.4 years, and 165 (59.1%) participants were men. A causative MRI finding was present in 101 (36.2%) patients. CNS infection was the commonest aetiology in 27 (9.7%), followed by infarct in 23 (8.2%), post-traumatic gliosis in 18 (6.5%) and neoplastic lesions in 17 (6.1%). Causative findings showed insignificant association with age group or gender (p>0.05).
Conclusion: A treatable structural abnormality was detected on MRI in a substantial minority of adults with new-onset seizures, with infective and vascular lesions predominating. The absence of meaningful variation in findings across age and gender groups supports a low threshold for MRI in all adults with a first seizure, irrespective of demographic characteristics.
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