Epilepsy in Diagnostic Imaging

Objectives What is it? Types of Seizures Signs and symptoms Cause Epilepsy Seizures Types of Seizures Primary Partial Absence Signs and symptoms Cause Diagnosis Tests Treatment Prognosis Roll of a Technologist Abnormalities MRI EEG SPECT PET

What is it? Epilepsy Seizures Central Nervous System disorder that causes seizures and loss of consciousness Seizures When the nerve cells in the brain abnormally signal Chemical imbalance of the starting and stopping of signals Epilepsy is not the only reason seizures occur Seizure- not always true for the reason of a seizure to happen

Types of Seizures Primary generalized seizures Partial seizures Both sides of the brain actively causing the seizure Partial seizures One part of the brain actively causing the seizure Absence seizures Not long lasting Blankly stare into space or have simple movements

Signs and Symptoms Partial Seizure- Primary General Signs and symptoms Migraines Lightheaded or dizzy Altered state of mind (emotions, smell, sight) Repetitive motions Primary General Stiffening of the muscles Loss of control of muscles Signs and symptoms Depend on type of seizure and person Common signs of seizures are confusion, staring into space, jerking of the body, loss of consciousness or awareness Some people are able to tell if they are going have a seizure Typically depends on the type of seizure and person Generally they will have temporary confusion, staring into space, jerking of the body, loss of consciousness or awareness Each person may or may not be able to tell if they are going to be having a seizure or not symptoms will be dependent of patient

Cause Any disruption of neuron activity Often unknown 6 of 10 are unknown Known brain injuries Typically before the age 10 Caused by head trauma or brain malformations Brain infections Genetics Stroke After the age 55 6 of 10 seizures are unknown cause Children- before 10 head trauma and brain malformations Geriatrics- after 55 stroke https://www.thoughtco.com/brain-basics-anatomy-373205

Diagnosis Details about the seizure or seizures Bring along whoever witnessed the seizure to inform the doctor of what happened EEG Blood tests CT and MRI PET SPECT Neuropsychological tests Multiple tests and close monitoring Bring along a family member or whoever was there to see it happening

Tests EEG Blood tests CT/MRI Abnormal brain wave patterns May have instructions to complete prior to the test to induce a seizure like lack of sleep, stress Blood tests Rule out other diseases CT/MRI Look for abnormal pathology in the brain Cysts, lesions, tumors, brain bleeds, ect. that could cause seizures https://commons.wikimedia.org/wiki/File:EEG_Recording_Cap.jpg May have instructions to complete prior to the test to induce a seizure like lack of sleep, stress Looking for cysts, lesions, tumors, brain bleeds, ect. that could cause seizures

Tests PET SPECT Neuropsychological test To help detect abnormalities PET scan is injecting a radioactive tracer into the vein to see if there are any abnormalities at a cellular level (brain tumors) SPECT Watch the blood flow in the brain looking for where the brain is seizing SPECT used when an EEG or MRI fails and is unable to locate where the seizing was happening. Is done when the patient is actively seizing assessing these areas to see where the seizures may be happening in the brain Neuropsychological test Assessing speech, memory, thinking skills https://samadimd.com/common-diseases/epilepsy-and-seizures PET scan is injecting a radioactive tracer into the vein and seeing if there are any abnormalities at a cellular level (brain tumors SPECT used when an EEG or MRI fails and is unable to locate where the seizing was happening. Is done when the patient is actively seizing Assessing these areas to see where the seizures may be happening in the brain

Treatment Right Medications Surgery Diet change Sleep pattern Some people have to take multiple medications and switch medications multiple times to find the right ones. Surgery If the reason for the seizures is a brain tumor or to fix whatever may cause the seizures. Diet change Sleep pattern Some people have to take multiple medications and switch medications multiple times to find the right ones. Surgery if the reason for the seizures is a brain tumor or to fix whatever may cause the seizures. Diet and sleep patterns could cause seizures https://www.healthline.com/health/epilepsy/facts-statistics-infographic#16

Prognosis Is not curable but can be controllable Can cause death if not controlled Can cause brain damage Depends on type of seizure, how long it is going on, and the person. Depends on type of seizure, how long it is going on, and the person.

Roll of a Technologist Positioning Technique Explanation and communication Optimal Images https://www.radiologyinfo.org/en/info.cfm?pg=fmribrain

EEG https://mmcneuro.wordpress.com/2013/02/17/epilepsy-and-seziures-whats-the-difference/

Seen on MRI: The “Birthmark” causing seizures or epilepsy “Brian birth mark” Causing seizures/epilepsy http://www.childneurologyfoundation.org/disorders/focal-and-multifocal-seizures/

After surgery to remove the area in hope of becoming seizure free http://www.childneurologyfoundation.org/disorders/focal-and-multifocal-seizures/

https://mmcneuro. wordpress https://mmcneuro.wordpress.com/2013/02/17/epilepsy-and-seziures-whats-the-difference/

PET SCAN Normal PET scan Epileptic PET Scan http://neurology.ufl.edu/patient-care/for-professionals/epilepsy/epilepsy-surgery/positron-emission-tomography-pet-scan/ Normal PET scan Epileptic PET Scan

SPECT Scan https://www.mayoclinic.org/tests-procedures/epilepsy-surgery/multimedia/pinpointing-seizure-location/img-20008881

References Bailey R. Brain and Their Responsibilities. 2018. Available at: https://www.thoughtco.com/brain-basics-anatomy-373205. Accessed March 21, 2018. Hope C. EEG Recording Cap. 2012. Available at: https://commons.wikimedia.org/wiki/File:EEG_Recording_Cap.jpg. Accessed March 21, 2018. Samadi D. Epilepsy and Seizures. 2015. Available at: https://samadimd.com/common-diseases/epilepsy-and-seizures. Accessed March 21, 2018. Holland K. Prognosis. 2014. Available at: https://www.healthline.com/health/epilepsy/facts-statistics-infographic#16. Accessed March 21, 2018. Patient Being Prepared For MRI Exam. 2016. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=fmribrain. Accessed March 21, 2018. Holland. Epilepsy and Seizures, What’s the Difference?. 2013. Available at: https://mmcneuro.wordpress.com/2013/02/17/epilepsy-and-seziures-whats- the-difference/. Accessed March 21, 2018. Ahmad S. Focal and Multifocal Seizures. 2018. Available at: http://www.childneurologyfoundation.org/disorders/focal-and-multifocal-seizures/. Accessed March 21, 2018. Positron Emission Tomography (PET) Scan. 2018. Available at: http://neurology.ufl.edu/patient-care/for-professionals/epilepsy/epilepsy- surgery/positron-emission-tomography-pet-scan/. Accessed March 21, 2018. Pinpointing Seizure Location. 2018. Available at: https://www.mayoclinic.org/tests-procedures/epilepsy-surgery/multimedia/pinpointing-seizure- location/img-20008881. Accessed March 21, 2018. Cunha J. Epilepsy (Seizure Disorder). Medicine New website. http://www.medicinenet.com/seizure/article.htm. Accessed March 21, 2018. Epilepsy Information Page. National Institute of Neurological Disorders and Stroke website. http://www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm. Updated April 3, 2017. Accessed March 21, 2018. Mayo Clinic Staff. Mayo Clinic website. http://www.mayoclinic.org/diseases-conditions/epilepsy/home/ovc-20117206. Accessed March 21, 2018. Shafter P. About Epilepsy. Epilepsy Foundation website. http://www.epilepsy.com/learn/about-epilepsy-basics. Accessed March 21, 2018.