Diagnosis of Epilepsy

Usually when diagnosis of patients that are said to have epilepsy, the patient’s medical history, including any family history of seizures, associated medical conditions and current medications are being taken into consideration. A complete physical and neurological examination of muscle strength, reflexes, eyesight, hearing and ability to detect various sensations are tested so that the cause of seizure of the patients can be determine.

Some of the tests used in evaluation of epilepsy:

a. Electroencephalography (EEG)
- Recording and measuring of electrical impulses in the brain
- Only test that directly detects electrical activity in brain
- Seizures are defined by abnormal activity in the brain, hence can be detected by EEG
- Diagnose seizure type by the different pattern of brain-wave activity- Localize the area of seizure onset
- During an EEG, a series of 32 electrodes are placed on the patient's scalp to record the electrical activity of the brain

b. Inpatient Video-EEG Monitoring
- Used to localize seizure onset in patients undergoing evaluation for epilepsy surgery.
- Used to confirm epilepsy when the diagnosis is uncertain

c. Magnetic Resonance Imaging (MRI)
- Allows detailed imaging of the brain
- Able to detect certain lesions in the brain that cause seizures
- Use special techniques, may detect very subtle asymmetries in the brain that may help determine on which side of the brain the seizures start

d. Neuropsychological Testing
- A patient's memory and cognition are measured
- E.g. IQ test
- Help identify areas of the brain that are not functioning normally, which provide clue as to the area of seizure onset
- Important component in pre-surgical evaluation as one risk of epilepsy surgery relates to the effects of surgery on memory and cognition

Sharon C.