What Does This MRI Report Indicate?

Brief Answer:
Truthfully, I'd prefer you DIDN'T have brain damage...better for you

Detailed Answer:
Thank you for your return question. I'm sorry you are not feeling better these days but I am glad you have a neurology appointment scheduled for September although if you came to XXXXXXX Ohio...I could get you in virtually inside of a several days!

I am going to repeat the options you have to prove the presence of either seizure activity in your brain or actual damage that can be visualized:

1. Detailed history and physical with respect to the feelings you now have to try and determine some localization in the brain based upon clinical criteria. For example, predominant symptoms or signs of forgetful or inability to recall short term memory could point to mesial temporal or hippocampal involvement. Extreme outbursts of rage or anger could point to damage to the amygdala. Odd changes to person's personality..for example going from a GO GO GO type of person to someone who is rather lethargic or apathetic compared to before could indicate some sort of THALAMIC or THALAMIC CIRCUIT problem.

2. MRI of the brain WITH gadolinium contrast and FINE CUTS through the temporal lobe. This type of MRI imaging is sometimes referred to as a SEIZURE PROTOCOL and not obtained nearly as often as one of imagine it should be obtained...even if being worked up by a neurologist....unless the neurologist is an epileptologist in which case I would expect all of them to properly ask for this type of study if a person were having issues.

3. NEUROPSYCHOLOGICAL evaluation....NOT neuroPSYCHIATRIC evaluation......but rather neuroPSYCHOLOGICAL evaluation with proper psychometrics done by experienced testers and clinicians. This type of battery of tests (especially when tailored according to a patient's symptoms) can be extremely useful in narrowing down the area or areas of abnormality in the brain and specify whether it is right or left side. Funnily enough, there are times when neuropsych testing has been show to be MORE accurate than EEG recording data simply because the sensitivity and specificity of an entire battery of tests performed in the right environment and done by skilled clinicians can "see" virtually EVERY part of the brain and EVERY domain of cognition whereas an EEG can ONLY see surface electrical activity closest to an electrode and therefore, is very INSENSITIVE to what may going on in the deeper regions of the organ especially the brainstem, the thalamic regions, and deep visual pathways.

Also PROLONGED surface EEGS can be done under different conditions with and without video monitoring.

4. PET scans or FUNCTIONAL MRI's can localize areas or points of activity in the brain either between seizures or during seizures missed by surface EEG's for the exact reasons I enumerated in #3.

5. Brain mapping where a mesh grid is place upon the brain...but this is an open surgical procedure that I would not recommend doing for someone unless they were having intractable motor seizures and were at risk for serious physical damage if the seizures cannot be stopped.

6.EEG with both a sleep deprived protocol as well as a 60 min. prolonged EEG recording. If after 2 standard studies there is nothing abnormal on the EEG and history and physical review provide compelling reasons to still suspect electrical abnormalities then, either a 6.5 hr. video recording could be made or even an in hospital 3-5 day video stay.

If, however, all electrical and other forms of imaging studies are negative then, the likelihood of a seizure disorder causing clinical symptoms is highly unlikely.

Stem cell injection and successful transplantation is certainly written about but the actual test data is still pending and probably won't be "people ready" for some time.

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Brief Answer:
Not all tests necessary

Detailed Answer:
I'm sorry that my last message may have confused you but the list was meant to remind you the list of options available to potentially detecting the presence of either a structural or functional problem.

By no means is it necessary to perform all the above tests. So, if there were 1 and only 1 test that I could suggest for the money to be paid it would be what is referred to as an INTERICTAL PET scan or perhaps a slightly less costly equivalent, FUNCTIONAL MRI.

Therefore, in my opinion if you wanted to choose the test with the greatest chance of showing problems it would be the PET scan and NOT the MRI with seizure protocol. The MRI with seizure protocol is a good bet if there is a good chance that one is expecting to find something on the order of a condition known as MESIAL TEMPORAL SCLEROSIS but this is not a commonly encountered problem. PET scanning during the interictal phase is much more sensitive for abnormal foci of activity.

I'm sorry that your mood is as low as you've indicated and I wish I had the solution to all of the problems you're having. Have you been speaking with someone in the field of County Social Services where you live who can assist with obtaining benefits of at least a medical nature if not possibly some fiscal assistance based upon both financial and/or medical disability if you're unable to work or locate a job?

If your question was adequately responded to could you do a favor and not forget to CLOSE THE QUERY?

I sincerely hope you start to feel a bit better and are able to take advantage of at least one of the suggested tests I mentioned in order to obtain the best treatment possible and start turning things around.

This query has utilized a total of 69 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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