Epilepsy & MRI: What a Brain Scan Can and Can’t Detect

March 22, 2023

Epilepsy is a common condition that can develop at any age and affects millions of people all over the world. In fact, there are over half a million people with epilepsy in the UK, which is around 1 in 100 people.

If you have been experiencing seizures or symptoms that may indicate you may have epilepsy, you may be referred for further testing, such as an epilepsy MRI scan.

In this article we shall explore epilepsy, including the common symptoms, seizures and how MRI scans can be useful for assessing, diagnosing and monitoring epilepsy.

What is Epilepsy?

Epilepsy is a neurological disorder, characterised by recurring and unpredictable seizures, which are caused by abnormal electrical activity in the brain.

Seizures can vary in severity and may involve a wide range of symptoms, such as convulsions, loss of consciousness, and sensory or emotional disturbances.

While the cause of epilepsy is often unknown, it can be related to genetic factors, brain injuries, infections, tumours, or other medical conditions.

Treatment options include medication, surgery, and lifestyle changes.

What are the symptoms of epilepsy?

The symptoms of epilepsy can vary depending on the type of seizure and the area of the brain affected.

The most common symptoms of epilepsy include:

  • Uncontrolled jerking movements of the arms and legs

  • Temporary confusion or disorientation

  • Sudden loss of consciousness or awareness

  • Staring spells

  • Fainting or blackouts

  • Unresponsiveness

  • Repetitive movements, such as chewing or hand rubbing

  • Sensory disturbances, such as tingling, numbness, or a feeling of deja vu

  • Emotional changes or mood swings

  • Loss of bladder or bowel control

Not all seizures are related to epilepsy, and not all people with epilepsy experience all of these symptoms. In some cases, seizures can occur without any visible symptoms, making diagnosis more challenging.

What causes epilepsy?

There are many different causes for Epilepsy which can be complex and sometimes hard to identify. A person might start having seizures because they have one or more of the following:

  • A genetic tendency, passed down from one or both parents (inherited).

  • A genetic tendency that is not inherited, but is a new change in the person’s genes.

  • A structural (sometimes called ‘symptomatic’) change in the brain, such as the brain not developing properly, or damage caused by a brain injury, infections like meningitis, a stroke, or a tumour.

  • Structural changes due to genetic conditions such as tuberous sclerosis or neurofibromatosis, which can cause growths affecting the brain.

What are epileptic seizures?

Epileptic seizures are sudden and temporary changes in brain activity that can lead to alterations in behaviour, consciousness, movements, sensations, or emotions.

They occur when there is abnormal or excessive electrical activity in the brain, which disrupts the normal functioning of the brain's cells and circuits.

There are many different types of seizures, ranging from mild and brief to severe and prolonged, and their symptoms and duration can vary widely depending on the part of the brain affected and the underlying cause.

Sometimes an individual may get a strange feeling or sensation before the episode and later on may forget and does not remember what happened.

People are diagnosed with epilepsy when they have had two or more seizures. An individual can be diagnosed with Seizures without having Epilepsy but cannot be diagnosed with Epilepsy without having Seizures. There are two types of seizures:
  • Generalised seizure
  • Focal seizures

Can MRI detect Epilepsy?

Magnetic Resonance Imaging, commonly know as an MRI scan, is a common test used for diagnosing epilepsy, as it provides detailed images of the brain's structure and activity. 

An brain MRI scan can be useful for epilepsy diagnosis and monitoring in the following ways:

Identifying abnormal structures

MRI can identify structural abnormalities in the brain that may be causing seizures, such as tumours, cysts, malformations of the brain, or scars from past injuries.

These abnormalities can be identified by comparing the MRI images to those of a healthy brain.

Evaluating brain function

MRI can be used to evaluate brain function by measuring changes in blood flow, which can indicate areas of increased activity in the brain that may be related to seizures.

Identifying the location of seizures

By combining MRI with other tests such as an EEG (electroencephalogram), doctors can identify the location of seizures in the brain. This information is important in determining the appropriate treatment for epilepsy.

Monitoring treatment

MRI can also be used to monitor the progress of epilepsy treatment, as it can show changes in the brain that may indicate whether the treatment is working.

Can MRI diagnose Epilepsy?

Whilst MRI scans are helpful, there is no one test can confirm or rule out a diagnosis of epilepsy.

Often it is a combination of test results, a person’s medical history, and information from those who saw the seizure(s), that is used to reach a diagnosis.

Precautions for Epilepsy

If you have seizure/epilepsy, you may experience discomfort from time to time. Some people may experience them more frequently than the others as every individual has a different representation and symptoms of epilepsy and the frequency of the seizures may vary.

Modern treatment methods, such as medication or surgery may help minimise the frequency and severity of your seizures.

Along with medicines prescribed by your doctor, you also need to take certain precautions in order to avoid any possible injury that can be caused to you while having an episode.

It is equally important to improve the safety of the places that you may frequently visit, including your home, office and others.

Here are some precautions to consider taking:

  • Avoid any triggering factors that may cause another episode for such as, lack of sleep, stress etc.
  • Avoid drinking alcohol.
  • Avoid tobacco and smoking.
  • Always wear a helmet while riding a bicycle or motorcycle, to help prevent head injuries.
  • Managing risk factors for stroke and heart diseases, which could cause brain damage that results in epilepsy.
  • Don’t use electrical appliances near water, to reduce the risk of electrocution if you have an episode
  • Avoid going near fire, gas stove, heaters etc.
  • Avoid visiting high places, such a walking near along cliffs
  • Avoid missing the dose of your medication and ensure regular check ups with your doctor.

We offers Epilepsy MRI scans but If you have epilepsy, please continue taking your prescribed medication unless your referring clinician or healthcare professional advises otherwise.


Our specialised brain mri scan provide detailed images to support the assessment of epilepsy and other neurological conditions.


Book your epilepsy brain MRI scan today with us for fast appointments, no GP referral required, and consultant radiologist reporting.


References:

National Institute for Health and Care Excellence (NICE). Epilepsies in children, young people and adults (NG217). Updated January 2025. https://www.nice.org.uk/guidance/ng217/chapter/diagnosis-and-assessment-of-epilepsy


National Institute for Health and Care Excellence (NICE). Evidence Review: Magnetic Resonance Imaging Scan to Detect Relevant Abnormalities in People with Epilepsy. Available at: https://www.nice.org.uk/guidance/ng217/evidence/a-magnetic-resonance-imaging-scan-to-detect-relevant-abnormalities-in-people-with-epilepsy-pdf-398366282810

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