Washington DC Epilepsy Care
An EEG provides a record of the electrical activity going on in the brain. A technician connects an EEG machine to specific parts of a patient's head using wires and electrodes. The electrodes pick up signals from the different parts of the brain and chart those signals as waves that change depending on activity. Epilepsy often produces abnormal brain waves not only during seizures, but also at other times. Physicians in The Epilepsy Center can interpret information from the charts to help make a diagnosis.
Magnetic Resonance Imaging (MRI)
An MRI makes detailed pictures of the brain by using a magnetic field and pulses of radio-frequency waves. It can detect abnormal blood vessels, tumors, scar tissue, and other lesions that may be responsible for producing seizures. For people with focal epilepsy, particularly those who may benefit from surgical treatment of drug resistant epilepsy, one of the most important factors in designing a successful treatment plan is to find some area on the brain MRI that is involved in starting the seizures. Unfortunately, in up to one-third of people with drug resistant epilepsy, conventional MRI still can't identify a lesion. Neuroscientists, radiologists, and engineers across the world are working hard to improve this. MRI machines are improving every year, and innovations in acquiring images have made structural MRI better and faster for identifying lesion. At GW Epilepsy Center, all patients receive dedicated MRI of the brain and the results are interpreted by an experienced neuroradiologist and discussed with the rest of the epilepsy team.
Functional MRI (fMRI)
The same MRI machine used for obtaining structural, still images of the brain can be used to look at the brain in action. This is called functional MRI or fMRI. fMRI looks at the changes in blood flow and oxygenation in the brain over a period of time, for example when someone is deliberately moving his limb, or silently name pictures that are shown to him/her on a screen. fMRI can reliably identify parts of the brain that are involved in speech or moving specific parts of the body. This is very useful information for the epilepsy surgery team to decide a personalized surgery plan that minimize the risk of causing unwanted deficit while maximizing the chance of total seizure control. At GW Epilepsy Center, we routinely use fMRI as a reliable non-invasive test and avoid more invasive tests for the same purpose. Some patients, however, may need to undergo invasive tests as well. fMRI is also used as a research tool in our center for finding the whereabouts of the lesion in the brain
Positron Emission Tomography (PET)
A PET scan uses a radioactive material called a tracer to highlight areas of concern in the brain.
Single Photon Emission Computed Tomography (SPECT)
Two scans of the brain are performed for this test: one during a seizure and another while the brain is functioning normally. Radioactive material is used to highlight the active sections of the brain and the two scans are compared. The seizure focus (the area that is producing seizures in the brain) is highlighted by subtracting the non-seizure scan from the seizure scan. This test often tremendously helps physicians to make surgical decisions.