Radiological management of patients with epileptic seizure

Napredak u radiologiji pružio je mogućnosti slikovnog prikaza raznih bolesti, uključujući epilepsiju. Epilepsija je bolest koja se povezuje s epileptičknim napadajima te posljedično dovodi do negativnih promjena na kognitivnoj, neurobiološkoj, psihološkoj i socijalnoj razini. S obzirom na složenost mozga kao organa, dijagnosticiranje ove bolesti zahtijeva precizne i pouzdane metode snimanja. Ističu se pretrage poput elektroencefalograma (EEG), kompjutorizirane tomografije (CT), magnetske rezonance (MR) i njenih naprednih tehnika te metode nuklearne medicine (PET, SPECT). Postoje indikacije za primjenu svake od navedenih tehnologija, međutim kada je riječ o epilepsiji MR je tada najčešći izbor snimanja mozga. Upotreba specifičnog MR protokola za epilepsiju uvelike je olakšala proces prepoznavanja i postavljanja dijagnoze ove bolesti. Protokol se sastoji od niza sekvenci koje u kombinaciji daju sliku potrebnu za uočavanje epileptogene promjene. Druge metode oslikavanja se primjenjuju kada je u pitanju hitnoća ili kada MR nalaz nije dovoljan za procjenu. To su naprednije i skuplje tehnike, ali kod određenih situacija neophodne u otkrivanju uzroka stanja u kojem se bolesnik nalazi. Postoji šest etioloških skupina uzroka te je potrebno utvrditi s kojom je povezana postojeća epilepsija. Evaluacijom slikovnog materijala može se doći do vrijednih informacija pomoću kojih se bolesniku može pružiti potrebna skrb.The development of radiology has given us the opportunity of imaging many diseases, epilepsy being one of them. This disease is associated to epileptic seizures and it can consequently lead to cognitive, neurobiological, psychological and social changes. Considering the complexity of the brain anatomy, diagnosing this type of disease requires precise and reliable imaging methods. The exams that stand out are the electroencephalogram (EEG), computed tomography (CT), magnetic resonance imaging (MRI) and its’ advanced techniques and also nuclear medicine methods (PET, SPECT). There are many indications for the use of these technologies, but when it comes to epilepsy the MRI is the most common choice for examining the brain. The use of the epilepsy dedicated protocol has helped in the process of recognizing and diagnosing this disease. The protocol consists of many sequences that, when combined, give an image that is needed for noticing the epileptogenic changes. Other forms of imaging are used when urgent or when the MR findings are not enough for the evaluation. Those methods are more advanced and expensive, but very necessary in some situations to find out the cause of the condition the patient is currently in. There are six etiologic groups of causes, and it is important to find out which one is associated to the epilepsy that the patient has. In order to give patients the care they need, it is obligatory to evaluate the images that hold the needed information