- The very first step, and probably the most critical one is to make sure that an individual has epilepsy.
- Without a correct diagnosis, treatment will surely be ineffective.
- A detailed medical history helps to establish the diagnosis.
Sometimes, it can be difficult to know if an individual is having a bout of seizure. It is also not easy for physicians to make a diagnosis on what type of epilepsy or seizure a person has since there are various disorders that can be confused with epilepsy.
The very first step, and probably the most critical one is to make sure that an individual has epilepsy. Knowing the type of epilepsy is really important. The events during a seizure attack also play an important role in making and arriving at the exact diagnosis. Tests are still needed to know more about the status of the brain and to identify the problems that are causing the disorder.
Without a correct diagnosis, treatment will surely be ineffective.
A thorough medical history helps in establishing the foundation for diagnosis. It rules out certain disorders that are similar with epilepsy and looks for the presence of other underlying medical conditions.
A neurological evaluation will be conducted by the physician. It involves testing mental functions, motor abilities, behavior, and other areas that can help diagnose the condition and identify the type of epilepsy a person has. Neuropsychological tests may also be performed as these can assess memory, speech skills, and thinking that can help determine the area of the brain that is affected.
A complete blood count is a lab test that is usually done. Doing a complete blood count helps in checking the presence of an infection or electrolyte abnormalities. In addition, a number of genetic conditions and kidney problems that may cause seizures might also be determined through lab tests. A toxicology screen may also be performed to determine poisons or drugs in the blood that can cause seizures. To rule out infections, a lumbar puncture is done. A lumbar puncture involves getting a sample of cerebrospinal fluid by inserting a needle into the lower back between the spinal column.
The electroencephalogram or EEG is the most important diagnostic procedure for epilepsy. The EEG records the electrical activities in the brain and monitors abnormal patterns or spikes. The abnormal patterns are a good basis for the diagnosis of epilepsy as many types of epilepsy are determined through these patterns. During EEG, electrodes are attached to the scalp using a paste-like substance. The electrodes will then record the electrical activities in the brain. For people with epilepsy, changes in the normal pattern of brain waves are common even if there is no attack of seizure.
A variant of EEG is the video EEG. It can be used during a seizure to know what happens inside the brain before, during, and after an episode of seizure. This test can be conducted either the patient is awake or asleep. Prior the test, the physician will give instructions to do something that can trigger seizures.
CT scans and MRI are used to identify the location of the abnormal brain activity. In addition, these imaging techniques can help rule out other conditions such as tumors and other abnormalities. Functional MRI is a diagnostic procedure that measures blood flow changes in specific areas of the brain while it is working. Lastly, single-photon emission computerized tomography (SPECT) is the test used if the EEG and MRI results cannot identify the part of the brain where the seizure is originating.