This type of structural abnormality is typically associated with epilepsy and is usually seen on conventional MRI scans, however high-resolution scans may be required in rare situations. A small number of studies have shown that patients with tuberous sclerosis complex (TSC) may also exhibit cortical tubers on MRI scans. TSC is a genetic disorder that increases your risk for developing cancer. Patients with TSC have an increased risk for developing certain types of cancer, such as brain tumors and kidney cancers.
Children with epilepsy often have multiple seizures every day. The cause of this problem can be found in many different places in the brain. Some areas of the brain are more likely to cause seizures than others. Epilepsy is when parts of the brain go into seizure mode too often. This can happen because of a physical injury to the brain, a disease such as tumor, stroke or infection, or even caffeine intake. The good news is that many people who experience a first seizure do not have another one soon after. In fact, many people who appear to be normal after a single epileptic episode will never have another one.
Epilepsy is diagnosed based on a patient's history and neurological examination. Your doctor will ask you about any previous seizures and their causes.
The scan reveals images of the brain that may reveal a physical cause of epilepsy, such as a brain scar. However, for many people, a brain scan may not reveal the source of their seizures, and even if no physical cause is discovered, the individual may still have epilepsy.
Epilepsy can affect how the brain functions by causing seizures to occur. During a seizure, the entire brain goes into chaos and loses control over certain muscles, including the mouth, throat, eyes, and body. After a seizure, the brain needs time to recover before it can work again. If a person with epilepsy does not take their medication or refuses to see a doctor, they risk having more seizures which could lead to long-term damage of the brain.
A medical history and physical examination are usually enough to diagnose epilepsy, but in some cases, such as when there is severe epilepsy with symptoms other than just feeling tired all the time, testing may be needed. Tests used to find the cause of epilepsy include magnetic resonance imaging (MRI), computerized tomography (CT) scans, electroencephalograms (EEGs), and blood tests. A neurological exam may also be done to look for signs of other problems that could cause epilepsy, such as tumors or AIDS.
People with epilepsy should discuss with their doctors potential risks vs benefits of various treatments, such as medications, surgery, and epilepsy monitoring.
An epileptic MRI protocol is a collection of MRI sequences designed to increase sensitivity and specificity in identifying probable structural abnormalities that underpin seizure disorders (e.g., mesial temporal sclerosis and malformation of cortical development). The protocol should be performed as soon as possible after diagnosis but at least within the first year of life.
The standard epilepsy protocol includes T1-weighted images of the whole brain (acquired with either a spin-echo or fast low angle shot sequence) and T2-weighted images of the brainstem and hippocampus (acquired with a fast spin-echo sequence). These sequences are obtained in the axial plane. Additional sequences may be required depending on the clinical presentation and findings on neurological examination. For example, if there is evidence of hydrocephalus, a fluid-attenuated imaging sequence would be indicated.
In addition to these standard sequences, other specific sequences may be used including diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), magnetic resonance spectroscopy (MRS), and functional MRI (fMRI).
A normal MRI does not rule out an underlying problem that could lead to seizures; additional tests may be needed. For example, if the patient has had a previous head injury and shows signs of concussion syndrome, a CT scan may be necessary to look for evidence of a blood clot.
The lack of a subjacent brain lesion and a neurological or intellectual disability describe idiopathic partial epileptic disorders. In the majority of instances, there is a clear genetic tendency. A family history of benign epilepsy is common. The age at onset is usually before 20 years of age and the frequency of seizures decreases with age.
Genetic factors play an important role in the development of this type of epilepsy. Mutations in more than 30 genes have been identified as causes of idiopathic partial epilepsies.
An accurate diagnosis of seizures and epilepsy is required for efficient therapy. Diagnostic studies can assist establish whether and where a brain injury is producing seizures. The doctor will begin by taking a history, which includes questions about the person's or parent's overall health as well as the seizures and their pattern of recurrence. The doctor may also ask how long ago the injury occurred.
A physical examination is done to look for signs of other problems that could be causing or contributing to the seizure activity. Tests may include:
Blood tests may be used to determine if the person has any underlying medical conditions or medications that might cause or contribute to the seizure activity.
Brain scans such as magnetic resonance imaging (MRI) or computerized tomography (CT) scan are used to identify any injuries to the brain not apparent in the first assessment. Scans may show damage to the brain tissue itself or abnormalities such as tumors or blood vessels that may need to be treated along with the seizure disorder.
Electroencephalograms (EEGs) monitor the brain's electrical activity over time, showing changes associated with seizures. Other tests may be done to confirm the diagnosis including genetic testing and video-electroencephalography (VEEG).
Treatment depends on what type of seizure is happening and what caused it. If a person has recurrent seizures, then they are likely to have another seizure if the cause is not removed.
Many epileptic individuals have normal EEGs between seizures. An abnormal EEG indicates that I have epilepsy. Many persons who do not experience seizures have modest EEG abnormalities. A clinical diagnosis is one that is determined based on a patient's history and examination. An EEG cannot make this diagnosis.
An electroencephalogram (EEG) is the recording of the electrical activity within the brain. It is useful in diagnosing epilepsy, evaluating its severity, and determining which parts of the brain are responsible for certain symptoms such as blindness, confusion, or loss of consciousness. An EEG can also help identify other conditions that may be causing or contributing to seizures, such as acute trauma to the head, infection, vitamin deficiencies, drugs, and alcohol.
The two main types of EEG recordings are standard EEG and video-electroencephalography (v-EEG). Standard EEG records the entire brain at one time; it is used to diagnose neurological disorders and to monitor patients during sleep or anesthesia. Video-EEG records selected portions of the brain while watching television or a movie; it is used to locate the source of seizures. Other types of examinations that may be performed along with the EEG include magnetic resonance imaging (MRI), computerized tomography (CT) scans, and neuropsychological testing.
Standard EEG recordings use multiple electrodes placed on the scalp in accordance with the 10-20 system.