Abstract: Introduction: it is well known that magnetic resonance imaging (MRI) has superiority above computed tomography (CT) in identification of epileptogenic substrates due to higher resolution of images and the best differentiation between white and gray matter. But in some peculiar cases, CT can be the method of choice. Aim: was to illustrate the role of CT in presurgical examination in children with drug-resistant focal epilepsy. Materials and methods: results of CT of 65 patients with focal epilepsy had been analyzed. All patients underwent multimodal presurgical examination with followed antiepileptic surgical operation and morphological analysis. CT was performed on GE Lightspeed and Philips Ingenity Elite scanners. Results: in presurgical period, native CT was performed in 11 (16,9%) patients and in 6 patients, structural brain changes responsible for epilepsy were identified. In 13 patients (20%) we’ve used CT angiography for estimation of angio-architectonic environment in the area of potential surgical intervention and in case of suspicion on arteriovenous malformation (AVM). CT on the 1st day of post-operative period was made in 48 (73,8%) of patients, and in 2 cases CT revealed structural changes that influenced further treatment tactics. At the background of exacerbation in 3 patients, repeated CT revealed sings of acute disorders of cerebrospinal fluid cirdulation. Conclusion: computed tomography can be an effective diagnostic method in examination of patients with epilepsy, especially when verifying bone and vascular (CT-angiography) changes, is used for neuronavigation to control the position of invasive electrodes and exclude post-implantation hemorrhages, and also helps to identify early postoperative complications, thus influencing tactics and outcomes of surgical treatment of epilepsy. In children with focal epilepsy undergoing surgical treatment, computed tomography and magnetic resonance imaging are complementary studies that provide adequate neuroradiological support. References 1. Fitsiori A, Hiremath SB, Boto J, et al. Morphological and Advanced Imaging of Epilepsy: Beyond the Basics. Children. 2019; 6(3): 43. https://doi.org/10.3390/children6030043 2. Baumgartner C, Koren JP, Britto-Arias M, et al. Presurgical epilepsy evaluation and epilepsy surgery. F1000Research. 2019; 8. https://doi.org/10.12688/f1000research.17714.1 3. Skjei KL, Dlugos DJ. The evaluation of treatment-resistant epilepsy. Semin Pediatr Neurol. 2011; 18: 150-170. https://doi.org/10.1016/j.spen.2011.06.002 4. Middlebrooks EH, Ver Hoef L, Szaflarski JP. Neuroimaging in Epilepsy. Curr Neurol Neurosci Rep. 2017; 17(4): 32. https://doi.org/10.1007/s11910-017-0746-x 5. Takanashi J. MRI and CT in the diagnosis of epilepsy. Nihon Rinsho. 2014; 72(5): 819-26. 6. Полянская М.В., Демушкина А.А., Костылев Ф.А. и др. Возможности режима SWI в магнитно-резонансной нейровизуализации у детей с фокальной эпилепсией. Эпилепсия и пароксизмальные состояния. 2020; 12(2): 105-116. Polyanskaya MV, Demushkina AA, Kostylev FA, et al. The role of susceptibility-weighted imaging (SWI) in neuroimaging in children with focal epilepsy. Epilepsy and paroxysmal conditions. 2020; 12(2): 105-116 [In Russ]. https://doi.org/10.17749/2077-8333/epi.par.con.2020.025 7. Cendes F, Theodore WH, Brinkmann BH, et al. Neuroimaging of epilepsy. Handbook of Clin. Neurol. 2016; 136: 985-1014. https://doi.org/10.1016/B978-0-444-53486-6.00051-X 8. Roy T, Pandit A. Neuroimaging in epilepsy. Annals of Indian Academy of Neurology. 2011; 14(2): 78. https://doi.org/10.4103/0972-2327.82787 9. Lapalme-Remis S, Cascino GD. Imaging for Adults With Seizures and Epilepsy. Continuum. 2016; 22(5): 1451-1479. https://doi.org/10.1212/CON.0000000000000370 10. Duncan JS. Brain imaging in epilepsy. Practical Neurology. 2018: 002180. https://doi.org/10.1136/practneurol-2018-002180 11. Tranvinh E, Lanzman B, Provenzale J, Wintermark M. Imaging Evaluation of the Adult Presenting With New-Onset Seizure. Am J Roentgenol. 2019; 212(1): 15-25. https://doi.org/10.2214/AJR.18.20202 12. Lompo DL, Diallo O, Dao BA, et al. Etiologies of non-genetic epilepsies of child and adolescent, newly diagnosed in Ouagadougou, Burkina Faso. Pan African Medical Journal. 2019; 31. https://doi.org/10.11604/pamj.2018.31.175.170 13. Goel D, Dhanai JS, Agarwal A, et al. Neurocysticercosis and its impact on crude prevalence rate of epilepsy in an Indian community. Neurol India. 2011; 59(1): 37-40. https://doi.org/10.4103/0028-3886.76855 14. Mengistu G, Ewunetu BD, Johnston JC, Metaferia GZ. Neuroimaging of Ethiopian patients with epilepsy: a retrospective review. Ethiop Med J. 2014; 52(2): 57-66. 15. Patel N, Jain A, Iyer V, et al. Clinico - diagnostic and therapeutic relevance of computed tomography scan of brain in children with partial seizures. Annals of Indian Academy of Neurology. 2013; 16(3): 352. https://doi.org/10.4103/0972-2327.116928 16. Cherian A, Syam UK, Sreevidya D, et al. Low seroprevalence of systemic cysticercosis among patients with epilepsy in Kerala, South India. J Infect Public Health. 2014; 7(4): 271-6. https://doi.org/10.1016/j.jiph.2013.08.005 17. Panov F, Li Y, Chang EF, et al. Epilepsy with temporal encephalocele: Characteristics of electrocorticography and surgical outcome. Epilepsia. 2015; 57(2): 33-38. https://doi.org/10.1111/epi.13271 18. Van Rooijen BD, Backes WH, Schijns OEMG, et al. Brain Imaging in Chronic Epilepsy Patients After Depth Electrode (Stereoelectroencephalography) Implantation. Neurosurgery. 2013; 73(3): 543-549. https://doi.org/10.1227/01.neu.0000431478.79536.68 19. Lee DJ, Zwienenberg-Lee M, Seyal M, Shahlaie K. Intraoperative computed tomography for intracranial electrode implantation surgery in medically refractory epilepsy. Journal of Neurosurgery. 2015; 122(3): 526-531. https://doi.org/10.3171/2014.9.jns13919 20. Schmidt RF, Lang MJ, Hoelscher CM, et al. Flat-Detector Computed Tomography for Evaluation of Intracerebral Vasculature for Planning of Stereoelectroencephalography Electrode Implantation. World Neurosurg. 2018; 110: 585-592. https://doi.org/10.1016/j.wneu.2017.11.063 21. Freyschlag CF, Gruber R, Bauer M, et al. Routine postoperative CT is not helpful after elective craniotomy. World Neurosurgery. 2018. https://doi.org/10.1016/j.wneu.2018.11.079 22. Fontes RB, Smith AP, Munoz LF, et al. Relevance of early head CT scans following neurosurgical procedures: an analysis of 892 intracranial procedures at Rush University Medical Center. J Neurosurg. 2014; 121: 307-312. 23. Almohiy H. Paediatric computed tomography radiation dose: A review of the global dilemma. World J. Radiol. 2014; 6: 1-6.
