Which neuroimaging studies are used in the diagnosis of epileptic seizures?

Updated: May 30, 2019
  • Author: David Y Ko, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

A neuroimaging study, such as brain magnetic resonance imaging (MRI) or head computed tomography (CT) scanning, may show structural abnormalities that could be the cause of a seizure. If the patient has normal findings on neurologic examination and his or her condition (eg, cognitive, motor) returns to the usual baseline level between seizures, the preferred study is a brain MRI because of its resolution, which can depict subtle abnormalities.

Not every brain MRI study provides the same quality of information. Studies obtained with 3.0 Tesla (T) scanners may show better resolution than do conventional 1.5 T scanners or the "open-sided" scanners of 0.5 T. Brain MRIs obtained for epilepsy should have thin coronal sections via fast spin-echo (FSE) or fluid attenuation inversion recovery (FLAIR) sequences from the presumed region of epileptogenic zone; these are useful for assessing cortical lesions, which may be amenable to potentially curative surgery.

There are many new advances in MRI sequences to help in epilepsy presurgical evaluation. For more information, see Identification of Potential Epilepsy Surgery Candidates regarding imaging studies.


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