Your guide to epilepsy MRI scans

  • April 14, 2021
  • 4
In this article

If you have recently started having seizures, your doctor may book you in for an epilepsy MRI scan. Magnetic Resonance Imaging (MRI) is one technique used to understand why you are having seizures. The epilepsy MRI findings might help diagnose the kind of epilepsy you have. Using MRI for seizures is also helpful during preparation for epilepsy brain surgery.

An MRI machine is an unusual looking device that you have to lie inside. You might be feeling a little nervous about the scan, but it’s painless and is completely safe.

Here is everything you need to know about MRI and epilepsy.

What is an MRI?

Magnetic Resonance Imaging is a medical procedure used to create an image of the inside of any part of your body. It uses a magnetic field and radio waves which can generate a picture of the structure of muscles and organs. MRIs also show how fluids move around the body.

Why am I being offered an epilepsy MRI?

Sometimes epilepsy is caused by specific abnormalities or damage to the brain. Using an MRI for seizures can show things like:

  • Damage to the brain caused by head injuries
  • Brain tumors
  • Structural problems
  • Issues with how blood flows through vessels in the brain
  • Sclerosis - which is when brain tissues hardens

If any of these problems show up on the epilepsy MRI findings, it will help your doctor to learn more about why you're having seizures.

An epilepsy MRI scan is also used if you are going to have surgery to remove a part of the brain that is causing seizures. The MRI will tell the surgeon exactly which part of the brain they need to remove and how much.

Other ways to diagnose epilepsy: What’s an EEG?

Does epilepsy show up on MRI scans?

No, not necessarily. An MRI scan can help your doctor understand some of the possible underlying structural causes of your seizures. However, for many people there is no structural cause behind their epilepsy and so the brain scan comes back ‘normal’.

Keep learning: Why do people get epilepsy?

Epilepsy MRI vs normal MRI

MRI specialists use many different techniques to study different illnesses. Some common MRI and epilepsy tests include

  • Functional MRI epilepsy scans which look at blood flow in the brain
  • Fiber tracking techniques which show the ‘wiring’ of the brain
  • FLAIR - a technique that helps detect changes around the edges of the brain

How to prepare for your epilepsy MRI appointment

Going into an MRI machine can be a strange experience. MRI machines are very noisy, and you may have to wear earplugs. The procedure normally lasts at least 30 minutes, and you must keep your head still so that the images are not blurry. This can be a little uncomfortable.

Here’s how to prepare for your epilepsy MRI appointment:

  • Tell your doctor and the technician at the hospital if you have any metal implants anywhere in your body - because this could affect how the machine works
  • If you find being in small spaces stressful, talk to the technician - they might provide medicines to help you relax
  • Take your seizure medicine as you usually do, and sleep and eat in your normal way
  • Wear loose-fitting and comfortable clothes that do not contain any metal fasteners or buttons
  • Avoid wearing jewelry, make up or hearing aids
  • If at any point during the procedure you feel uncomfortable, there will be a button you can press to communicate with the technician

MRI seizure protocol for people with epilepsy

Different hospitals will have their own MRI seizure protocol for patients, depending on the sort of epilepsy you have. The hospital should explain their exact protocol (the official steps to follow for an MRI) for you in advance. But it usually will include these steps:

  • You will take your medication as usual on the day of the MRI
  • Avoid caffeine (from coffee, tea, energy drinks or cola) for at least 24 hours before the MRI
  • Remove any metal items, and put on a hospital gown
  • Get onto the flatbed and enter the MRI machine

The technician will follow specific MRI seizure protocol depending on the kind of epilepsy you have. Some of the tests might include:

  • T1-weighted and enhanced T1 weighted
  • T2-weighted
  • Contrast enhancement (a special fluid is injected into your veins which makes it easier to see what’s happening in the brain)
  • fMRI - or Functional MRI
  • Once the MRI has been completed, the images will be processed and analyzed by the technician and a neurologist.

Is an MRI safe?

Yes, MRI scans are among the safest medical procedures around. While they are noisy and a bit uncomfortable, you’ll experience no physical danger.  

What happens after the epilepsy MRI test?

After the test is complete, a radiographer and your neurologist will analyze the epilepsy MRI findings. This information will be used to understand your seizures and decide on the best treatment pathway for you.

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