Which imaging study is used to assess brain structure in seizure workup?

• A. Electroencephalogram (EEG)
• B. Brain Magnetic Resonance Imaging (MRI)
• C. Liver Function Tests
• D. Carotid ultrasound

Answer: (B)

Brain MRI is used to assess brain structure in seizure workups because seizures often originate from structural abnormalities in the brain, such as tumors, cortical malformations, hippocampal sclerosis, vascular malformations, or scar tissue. MRI provides superior soft-tissue contrast and multiplanar detail, making it highly sensitive for detecting subtle lesions that may not be visible on other imaging. Different MRI sequences (like T1, T2, FLAIR, and diffusion) highlight various tissue properties and pathologies, helping to identify both acute and chronic structural changes. This structural information is crucial for guiding treatment decisions, including the consideration of surgical options. In contrast, procedures that measure electrical activity (like EEG) or assess liver function or carotid arteries do not visualize brain structure, so they don’t serve the same purpose in identifying structural causes of seizures.