causes

How is Epilepsy diagnosed?

There are a number of resources a physician will use to determine the diagnosis of epilepsy. Medical history obtained from the patient is essential to the diagnosis. A careful description of the circumstances and events before, during and after the seizure provides critical clues in determining if the diagnosis is epilepsy. Reports from the patient and witnesses provide valuable information to the physician.
There are tests conducted which may help determine the diagnosis of epilepsy. Not all patients require all of these tests.

a) Electroencephalogram (EEG) is the most specific test for diagnosing epilepsy because it records electrical brain function (remember, epilepsy is a disorder of abnormal electrical function). By using small electrodes (flat metal disks) attached to the scalp with a sticky paste, the electrical activity produced by the brain is recorded. The test is painless and harmless and takes approximately one and a half hours from start to finish.
Sometimes the brain functions perfectly normally during an EEG. Therefore, patients with epilepsy do not necessarily always show an EEG abnormality with a single recording. The abnormal electrical discharges are more likely to be detected after multiple or prolonged recordings. Persons may sometimes be asked to stay awake all night before having an EEG because abnormal electrical activity may express itself during the EEG test after sleep deprivation. The EEG pattern recorded helps define the type of the seizures.
b) Video EEG Telemetry A routine EEG (even with sleep deprivation) may not provide the information needed for diagnosis and treatment. It may be necessary to record the EEG during actual seizures. To undergo Video EEG Telemetry, a person must be admitted to hospital and be monitored, both by EEG and a video camera, twenty-four hours a day. Video EEG Telemetry is critical in the preoperative evaluation of persons being considered for epilepsy surgery

c) Computerized Axial Topography (CT Scan) examines brain structure. During a CT Scan, a thin beam of X-rays is focused around the head. The X-ray tube moves around the site taking many pictures which are processed by a computer. A special “dye” may be injected to make the pictures clearer.
This test is performed to try and identify a cause for the epilepsy or seizures (stroke, tumor, etc).
d) Magnetic Resonance Imaging (MRI Scan) provides very precise and life-like pictures of brain structure, using a very large magnet, radio waves and computer. Like the CT scan, the MRI scan is also performed to try to find a cause for the diagnosis of epilepsy.
e) Neuropsychology Memory problems and other cognitive difficulties are common in persons with seizures. The psychologist who performs the neuropsychological evaluation will assess your particular situation. This is done through an interview and some testing. The psychologist will ask about how epilepsy has affected your personal, social, academic, and vocational life. In addition, the psychologist will give you paper and pencil tests of memory, attention, thinking, reasoning motor skills, language, and spatial skills. The neuropsychological evaluation takes about five hours broken up into shorter sessions.
A neuropsychological evaluation can discover if speech functions are controlled by the left or right side of your brain. Secondly, the pattern of strengths and weaknesses you show on the test results tells the doctor what parts of the brain might be healthy or compromised.

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Thirdly, the neuropsychological evaluation can assist in the identification of epilepsy surgery candidates who might be at risk for serious memory or speech disorders.
f) Sodium-Amytal Testing Prior to epilepsy surgery, a patient may undergo sodium-amytal testing in order to make sure that memory and speech functions are not located in the part of the brain that will be removed. The neuroradiologist injects a medication into the blood supply to the brain, putting half of the brain to sleep for approximately 10 minutes. During that time, the neuropsychologist questions the patient to reveal which functions are preserved in the “awake half” of the brain. The sodium-amytal test takes approximately one hour to complete.