Understanding my MRI analysis

[Brighton]

Can anyone help? Even if it just answering just one of the questions .

I have just opened a letter from my neurologist post my first MRI, I had first seizure for 15 years and it is being suggested I go on lamotrigine. I am still waiting for EEG results but I do not really understand the following from letter?...

"there is however comment of some very subtle asymmetry in area called medial temporal lobe which in some individuals is associated with tendency towards seizures. Although this was reported as equivocal it is possible it may represent a developmental change leading to a predisposition for seizures"

With no previous MRI how can it be a developmental change ? What does equivocal mean here in lay terms, that it is just a guess? Does anyone know in how many people such asymmetry results in seizures? Are brains like most bodies and not often symmetrical? Or is that metaphor not applicable?

She goes on to say " the issue is really restarting anticonvulsants and I think if anything this scan adds further weight to the idea that seizures may recur"

On a personal level would such a reading make you take up lamotrigine having been fit free for 15 years previously on no meds?
I have posted previously with the dilemma re going back on meds but this letter hasn't so far made it much clearer. Thanks for your time if you have read this .

 

[epileric]

With no previous MRI how can it be a developmental change ?

The say

Although this was reported as equivocal it is possible it may represent a developmental change leading to a predisposition for seizures.

I don't think they are saying it is a developmental change but because of no previous MRI is very much a possibility.

What does equivocal mean here in lay terms, that it is just a guess? Does anyone know in how many people such asymmetry results in seizures? Are brains like most bodies and not often symmetrical? Or is that metaphor not applicable?

Equivocal means that the MRI might mean more than one thing & that this is just one of the things possible that need to be investigated- not definite but more than a guess.

She goes on to say " the issue is really restarting anticonvulsants and I think if anything this scan adds further weight to the idea that seizures may recur"

On a personal level would such a reading make you take up lamotrigine having been fit free for 15 years previously on no meds?
I have posted previously with the dilemma re going back on meds but this letter hasn't so far made it much clearer. Thanks for your time if you have read this .

She does say that she feels that the scan adds weight for the argument to take up Lamotrigine. If it makes you feel more comfortable then you might want to wait until you have another seizure. Just remember that the more seizures you have the more your brain remembers misfiring in those places & is more likely to repeat it again & again.

Personally I would after a 2nd seizure because that is showing that my neural behaviour has changed.

 

[Brighton]

Thanks for your response. When you say I could wait for a second as it would show change, does that mean you wouldn't class this one as definitely a change.
I am in such a dilemma as I am now 9 months seizure and med free but surfing isn't quite the same and I get my licence back in feb and that poses ethical questions also.

 

[Zolt]

Hey Brighton,

In order to be an Epileptic, one needs to having 2 or more seizures on a regular basis. Have you had 2 seizures in the last 15 yrs?

Was there something that you may have done to provoke that seizure happening? Like drinking heavily in previous days leading up to your seizure? Or Lack of sleep?

What type of seizure did you have, a grand mal, or a smaller one?

On the MRI stuff, I have email access to my doctors, so if you do, email them asking for a better explanation of what they mean. I normally get a response back from my doc the same day. I've had over 14 + MRI and right after i have my MRI done, I go straight to the records department and request to have a copy of my mri images that were just taken. Within 15 min, i have the CD of the mri in my hand. I always take the day off when i have an mri, so afterwards i'll go home and look at and compare it to the last mri I had. Ask them to tell you on what image/slide they see that change that they are talking about.

Also you can take that mri picture and send it to other clinks that may offer a second opinion.

I know i didn't answer your question, just giving you some thoughts to think about.

iano: op:

 

[epileric]

Thanks for your response. When you say I could wait for a second as it would show change, does that mean you wouldn't class this one as definitely a change.
I am in such a dilemma as I am now 9 months seizure and med free but surfing isn't quite the same and I get my licence back in feb and that poses ethical questions also.

I wouldn't class it as anything as I'm not a neurologist. What I was saying was that if it was me I personally would wait for a 2nd seizure (no matter how small) to make sure this wasn't a 1 time thing. That is just my personal view of how I would deal with it but I would still keep in touch with my neurologist for tests to see if they can determine the cause.

 

[Brighton]

Thanks for responses, an impossible thing I know for people to advise on! Just helps talking to people who know. I have had 1 now in 15 years but am just concerned re consequences of next one with the lifestyle I am lucky to have cycling, surfing etc.
a crystal ball would be a bonus!