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What Is an MRI & a CAT Scan & How Do They Diagnose Epilepsy?

Learn how MRIs and CAT scans are used to evaluate patients with epilepsy from Steve Wolf, MD and Patty McGoldrick, NP in this Howcast video.

Transcript

MRIs and CAT scans are frequently used to evaluate patients who've had epilepsy. MRIs don't use any radiation. They use magnets to basically look at the brain. They give us a much better detailed picture of the brain to look at how the brain developed, see if there's any funny unusual blood vessels or anything else like that. CAT scans are used if somebody comes in with a first seizure or head injury and that gives a more gross picture off the head. So, you get more of a, sort of the bones and you can tell if there's a bleed going on or if there's some big nasty tumor sitting in there. But, they should just be a first sort of emergency neuroimaging. Yeah. So, CAT scans are typically used in the emergency room after the first seizure. But, if someone has a perfectly normal examination, you're not necessarily going to do it because a CAT scan's only going to eliminate abnormal blood vessel popping or bleed in the head, or head trauma. It'll look for a quick brain tumor. So, it's a good screening tool. But, someone with real epilepsy, you're going to want a really good MRI. And so you need a good MRI, which is a 3T machine. You need thin cuts. So, what an MRI does is it sort of cuts the brain into segments going this way and sideways. And it gives you a 3D representation of the brain. So, you want very thin cuts so that you can see at very small levels of the brain what exactly is going on, and if there's something there that could be causing seizures. So, when you're discussing with the people who take care of you, "Did I have an MRI? Did I have a CAT scan?" you want a good, quality MRI. Make sure you're not missing anything on there, making sure that there's no abnormal cortical dysplasia or migrational defect that could cause the epilepsy. And a CAT scan is not what we recommend. It's a good MRI read by experts who read brain MRIs all the time. And that will guarantee that you've got a good evaluation.

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