Overall success in detecting lesions in focal epilepsies with CT is much lower than with MRI at only 30% [17]. Importantly, the ILAE recommendation for neuroimaging in the acute situation is for CT if there is a need to have ready access to the patient during scanning. [15]. FDG-PET/CT Brain There is no relevant literature regarding the use of FDG-PET/CT as an initial imaging study in the evaluation of new-onset seizure unrelated to trauma. MEG There is no relevant literature regarding the use of magnetoencephalography (MEG) as an initial imaging study in the evaluation of new-onset seizure unrelated to trauma. MRI Functional (fMRI) Head There is no relevant literature regarding the use of functional MRI (fMRI) as an initial imaging study in the evaluation of new-onset seizure unrelated to trauma. MRI Head MRI serves multiple purposes for new-onset seizures, including identifying and characterizing focal causative lesions as well as assessing progression. MRI is an important tool for determining prognosis as well as a treatment strategy. In the nonemergent situation, MRI is the imaging study of choice when indicated [15-18]. In an emergent setting, CT may be quicker as it does not require additional safety screening and has decreased requirements for extended patient monitoring [16]. In general, all patients with epilepsy should undergo an MRI. Some forms of epilepsy, however, have a low yield of structural lesions on MRI, such as those with typical forms of primary generalized epilepsy, benign focal epilepsies of childhood with characteristic clinical and electroencephalography (EEG) features, and early onset childhood epilepsy with occipital spikes and adequate response to antiepileptic drugs, so in these cases, some authors do not advocate utilizing MRI [17]. Seizures and Epilepsy use of intravenous (IV) contrast is not routinely necessary; however, it is useful when images without IV contrast are not sufficient or if neoplasm or inflammatory condition is suspected [17].
Seizures and Epilepsy. Overall success in detecting lesions in focal epilepsies with CT is much lower than with MRI at only 30% [17]. Importantly, the ILAE recommendation for neuroimaging in the acute situation is for CT if there is a need to have ready access to the patient during scanning. [15]. FDG-PET/CT Brain There is no relevant literature regarding the use of FDG-PET/CT as an initial imaging study in the evaluation of new-onset seizure unrelated to trauma. MEG There is no relevant literature regarding the use of magnetoencephalography (MEG) as an initial imaging study in the evaluation of new-onset seizure unrelated to trauma. MRI Functional (fMRI) Head There is no relevant literature regarding the use of functional MRI (fMRI) as an initial imaging study in the evaluation of new-onset seizure unrelated to trauma. MRI Head MRI serves multiple purposes for new-onset seizures, including identifying and characterizing focal causative lesions as well as assessing progression. MRI is an important tool for determining prognosis as well as a treatment strategy. In the nonemergent situation, MRI is the imaging study of choice when indicated [15-18]. In an emergent setting, CT may be quicker as it does not require additional safety screening and has decreased requirements for extended patient monitoring [16]. In general, all patients with epilepsy should undergo an MRI. Some forms of epilepsy, however, have a low yield of structural lesions on MRI, such as those with typical forms of primary generalized epilepsy, benign focal epilepsies of childhood with characteristic clinical and electroencephalography (EEG) features, and early onset childhood epilepsy with occipital spikes and adequate response to antiepileptic drugs, so in these cases, some authors do not advocate utilizing MRI [17]. Seizures and Epilepsy use of intravenous (IV) contrast is not routinely necessary; however, it is useful when images without IV contrast are not sufficient or if neoplasm or inflammatory condition is suspected [17].