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What tests are performed before epilepsy surgery?

The primary components of the pre-surgical evaluation for epilepsy surgery include:
  • A detailed clinical history and physical examination
  • A high resolution magnetic resonance imaging (MRI) scan of the brain
  • Functional imaging: This is an attempt to see changes in brain metabolism using the uptake of glucose with a radioactive atom in it, called positron emission tomography (PET scan). A PET scan is used to identify areas of hypometabolism (decreased glucose uptake), which may be associated with a seizure focus identified by other studies. Single photon emission computer tomography (SPECT scan), which looks at blood flow, may also be used.
  • Continuous video electroencephalogram (EEG) monitoring: an inpatient hospital stay for three to seven days for 24-hour video and EEG surveillance. The goal is to allow the patient to have his or her usual seizures in order to localize where the seizures come from. During the admission, the patient's medications may be reduced so that a seizure is more likely to occur.
  • Neuropsychological testing: A neuropsychological assessment can provide essential data that is helpful for identifying areas of altered brain function/thinking that may be related to where the seizures originate. Language function, memory (both verbal and visual), and visuospatial capability are examined. These tests last several hours and require some patience. By examining the pattern of test results, the neuropsychologist is able to identify the patient's specific areas of decreased function in the brain.
  • Assessment of psychosocial functioning: psychological, social and psychiatric assessment plays an important role. With this evaluation, the expectations of surgery and the postoperative adjustment are explored.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.