Ring or Disc-like Enhancing Lesions in Partial Epilepsy in India

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Abstract
One-hundred unselected children presenting with partial motor seizures were subjected to clinical work-up and cranial computed tomography (CT scan). Seventy-three children had an abnormal scan. On these, 56 patients had either a ring (35 patients) or a disc-like (21 patients) enhancing lesion which coincided with the probable site of origin of the seizures in all cases. The lesions were surrounded by perifocal oedema which was occasionally severe enough to produce a mass effect. The significance of these disc or ring lesions is discussed in the light of recent literature. All patients with such lesions were put on three-drug anti-tubercular therapy along with anticonvulsants. A repeat scan could be obtained in 20 patients, 10 weeks to 1½ years after the initial scan. This showed a decrease in size or disappearance of the lesion in the majority (13 patients). Four patients showed a spot of calcification in the area of the original lesion and another two showed a typical ‘target sign’, i.e. calcification within a ring. It is concluded that these ring or disc lesions represent tuberculoraas which are, thus, the commonest cause of partial motor seizures in children in this area.