Epilepsy Diagnosis and Neuroimaging
Seizures occur when the brain fires abnormal electrical signals. At Children’s Hospital Los Angeles, we use a comprehensive range of evaluation and neuroimaging tools to diagnose epilepsy and other seizure disorders.
Neuroimaging, or brain scanning, and brain activity testing help epilepsy specialists pinpoint the exact location of a seizure. Specialists make epilepsy diagnoses based on these tests. When we diagnose seizures quickly and accurately, children benefit from more effective and timely treatment.
Epilepsy Tests and Neuroimaging Options
Our team offers advanced options for epilepsy diagnosis. Epilepsy imaging may include:
- Electroencephalogram (EEG)
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET) scan
- Single-photon emission computerized tomography (SPECT) scan
- Source localization via current reconstruction and imaging (CURRY) software
An EEG records brain wave activity. Seizures may show up as abnormal patterns, sudden changes or interruptions to brain waves. EEGs are one of the primary tests used to diagnose epilepsy.
We have an ABRET-accredited EEG center. This recognition means we follow best practices to provide high-quality EEG testing.
Preparing for your EEG
During an EEG, specialists place tiny electrodes on top of your child’s head with a special paste. The electrodes connect to a computer that records brain wave activity. Download our guides to find out about preparing for EEG testing:
Sometimes we use ambulatory EEGs, where the child can go home the same day of testing. In other cases, children may stay overnight for EEG testing in the Inpatient Epilepsy Monitoring Unit (EMU).
Our EMU uses continuous video EEG monitoring, which combines the EEG brain wave data with live video of your child. This allows us to see what your child is doing when the EEG shows seizure activity. Our specialists monitor the video EEG feed 24/7 and can provide immediate treatment when needed.
MRI machines use magnets and radio waves to create two- or three-dimensional brain images. We also use 3T and functional MRIs, which are among the most advanced imaging options available for diagnosing epilepsy.
During an MRI, your child lies on a flat bed inside the MRI machine. This machine looks like a long cylinder that’s open on both ends. Usually, MRIs last for at least (average) 30 minutes. Most of the time, your child can have one parent stay in the room during the MRI scan. Often, patients can watch movies or listen to music with goggles and headsets during MRIs.
Like traditional MRIs, 3T MRIs highlight brain structures and structural changes. The magnet in a 3T MRI is stronger than in a traditional MRI. Because of this, 3T MRI machines create more detailed images of the brain.
A functional MRI (fMRI) uses magnets to take pictures of the brain’s blood flow. When a part of the brain is active, more blood flows to that area. During an fMRI, the technician may ask your child to perform certain movements, such as wiggling the fingers or toes, to activate specific parts of the brain.
Specialists use fMRIs to pinpoint the exact seizure location by evaluating areas of high blood flow in the brain. This information about the seizure location guides our specialists in selecting the most effective treatment techniques.
A PET scan can show the exact location where a seizure begins. We may use PET scans if your child needs brain surgery to remove a tumor as part of the epilepsy treatment plan.
Before a PET scan, patients aren’t allowed to eat, because the test measures how sugar is metabolized in the brain. During a PET scan, your child receives an injection of a safe radioactive substance. This substance gathers in areas of the body that have high levels of chemical activity, such as in a tumor, and can show up on a scan. PET scans are performed while a patient is not having a seizure. An EEG is performed at the same time to ensure that a seizure is not happening.
SPECT scans pinpoint areas of the brain where blood flow is high. These scans use a safe, injectable dye that gathers in areas of the brain where there is increased blood flow. We can measure where the dye gathers for about four to six hours after the initial injection.
SPECT scans are performed while a seizure is happening. When a seizure starts, we inject the dye so that it highlights the “hotspot” in the brain where the seizure is occurring. Shortly after the seizure, we take an image of the brain to see where the substance has gathered. We compare this image to a brain scan taken when your child is not having a seizure, to find the location of the seizure.
To determine the source of your child’s epilepsy, multiple neurophysiologic and neuroimaging studies may be required. Often, these two-dimensional studies do not give a complete picture, so we use CURRY software to combine data from these studies in one place.
The software enables us to merge your child’s neurophysiologic results (EEG) with their neuroimaging results (MRI, fMRI, PET or SPECT) and create two-dimensional and three-dimensional brain maps.
The brain maps help us:
- Locate and compare abnormalities from the individual studies
- Visualize the suspected source of your child's epilepsy in a three-dimensional manner
- Better guide medical and/or surgical treatment
Epilepsy Treatment Options
After an epilepsy diagnosis, our specialists use advanced treatment options to prevent seizures from recurring. A child’s treatment plan may involve medication, diet therapy or neurosurgery. Learn more about treatment for epilepsy in children.
Comprehensive Epilepsy Center at Children’s Hospital Los Angeles
We offer epilepsy treatment through several clinics and programs. Discover the options our Comprehensive Epilepsy Center offers your child.