All About Epilepsy part 2

If you have epilepsy, it is essential to be aware of all the tests you will have (non-academic, don’t worry!) One of the most common tests a person with epilepsy frequents, is an Electroencephalogram, or EEG in simple terms. This noninvasive test involves placing electrodes on the scalp, and records electrical impulses in the brain. An EEG is essential in detecting any irregular activity such as a seizure. An EEG can help a neurologist determine where in your brain seizures are coming from and where to go with treatment. Magnetic Resonance Imaging (MRI) is also noninvasive and scans using a magnetic field, producing three-dimensional images of the brain to help locate the area seizures originate.  The Single Photon Emission Computed Tomography (SPECT) is used to observe how blood flows through arteries and veins in the brain. The SPECT is not as common and is typically used for presurgical evaluation. Computerized Axial Tomography (CAT Scan) / Computed Tomography (CT Scan) these are both noninvasive tests used to create a three-dimensional image of the brain. Unlike the MRI, which uses magnetic imaging, these use X-ray to show any abnormalities in the brain such as tumors, scar tissue, and more. Positron Emission Tomography (PET) is a test that uses scanning to detect chemical and physiological changes related to metabolism. This test provides 3-dimensional images of blood flow, chemical reactions, and measures metabolism of glucose and oxygen in the brain. During a PET scan, you will be injected with a radioactive substance for the computer to create images of the brain’s specific functions. This scan is also used for presurgical evaluation, as well as testing for surgery candidates. Magnetoencephalography (MEG) Like the MRI, the MEG uses magnetic imaging from detectors placed near the head. Magnetic waves are then used to measure brain activity. This test is similar to an EEG, but it can detect signals deeper in the brain by using the magnetic signals. The Intracarotid Sodium Ambobarbital Test (Wada Test) the most interesting test of them all! This test is only done before brain surgery, to give the neurosurgeon the most accurate section of the brain to do surgery on. This test determines which side of your brain your language and memory abilities are located. By determining which side of your brain controls each function, your neurosurgeon is able to determine if you will be at risk of changes to speech or memory. A team composed of a neurosurgeon, epileptologist, interventional neuroradiologist, and a neuropsychologist conduct this test. Once in the operating room, your medical team will numb the skin in your groin region. Once numb, a wire with a catheter will be inserted into your femoral artery. They will then work the catheter up to the carotid artery. The Interventional neuroradiologist will then put half of your brain to sleep. When the medicine goes to the right, you won’t be able to communicate with the left side of your body.(They may ask you to count to 10 and you slowly become unable to count). If the medicine goes to the left, you will lose mobility on your right side. The Neuropsychologist may or epileptologist may ask you to try to remember visuals. Once the test is over, they will make sure your brain is back to normal by using EEG. After the test, the neurosurgeon has a much clearer idea of places to avoid.  Blood tests and Genetic testing are also vital to determine underlying problems that may be triggering seizures. Lastly, Stereoelectroencephalography ( SEEG) is an invasive surgery done where electrodes are placed through the skull creating access for depth electrodes. (wires implanted deep into the brain to map seizures). During this surgery you are put to sleep (obviously) so the results are more accurate than a typical EEG. This procedure is done to plan if surgery is an option.