An epileptic MRI protocol is a collection of MRI sequences designed to increase sensitivity and specificity in identifying probable structural abnormalities that underpin seizure disorders (e.g., mesial temporal sclerosis and malformation of cortical development). The protocol should be performed as soon as possible after diagnosis but at least within the first year of life. The standard epilepsy protocol includes T1-weighted images of the whole brain (acquired with either a spin-echo or fast low angle shot sequence) and T2-weighted images of the brainstem and hippocampus (acquired with a fast spin-echo sequence). These sequences are obtained in the axial plane. Additional sequences may be required depending on the clinical presentation and findings on neurological examination. For example, if there is evidence of hydrocephalus, a fluid-attenuated imaging sequence would be indicated. In addition to these standard sequences, other specific sequences may be used including diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), magnetic resonance spectroscopy (MRS), and functional MRI (fMRI). A normal MRI does not rule out an underlying problem that could lead to seizures; additional tests may be needed. For example, if the patient has had a previous head injury and shows signs of concussion syndrome, a CT scan may be necessary to look for evidence of a blood clot.