Epilepsy is diagnosed based on the history and tests that are done to confirm the diagnosis. Some of the tests that may be done include electroencephalography (EEG), brain imaging (CT, MRI, PET) and blood tests.
Epilepsy is considered as the possible cause of seizures based on the history and tests that are done to confirm the diagnosis.
Medical history: This is the first and an important step for making a diagnosis of epilepsy. The doctor will take a complete medical history and ask questions regarding:
- Family history of seizures (if you have a family history of seizures, you are more likely to develop seizures).
- Description of the seizure (what was the seizure like).
- What happened before the seizure started.
- Other possible causes of seizures other than epilepsy such as alcohol withdrawal, infections, head injury or drug abuse.
As the person may not be aware of what happened during the seizure, the doctor will ask the family member/s for details of seizure and post-seizure.
Your doctor will recommend a number of tests to confirm the diagnosis of epilepsy. Some of the tests that may be done include:
- Brain imaging (CT, MRI and PET).
- Blood tests.
Electroencephalography (EEG) is done if epilepsy is considered as the possible cause of seizures.
It is the most frequently done test for epilepsy. During the test, electrodes are attached to the scalp to read the brain's electrical messaging system. It records and prints electrical signals as they travel through your brain. In people with epilepsy, the brain wave patterns are unlike recording from a healthy brain even when the person is not having a seizure while the recording is done. The EEG patterns of some types of epilepsy are very characteristic. In some cases, EEG is most accurate when it is performed within 24 hours of a seizure. The EEG test requires about an hour and is done in a doctor's office or as an outpatient at the hospital. If the diagnosis is not clear on a simple EEG, recording a 24-hour recording of the brain activity may be done. In this test, you will be made to wear a portable monitor for 24 hours as you carry on with your normal activities and the electrical signals of the brain will be recorded.
Brain imaging tests such as computerised tomography (CT or CAT scan) and Magnetic Resonance Imaging (MRI) are usually done when an adult has had his/her first seizure or when a child has seizures without fever. Both the tests are painless and non-invasive tests that take a series of detailed pictures of the part of the body that is being examined. They show the structure of the brain and are useful to identify tumours, cysts and other structural abnormalities that may be the cause of seizures. Positron Emission Tomography (PET) and functional MRI (fMRI) are useful to monitor the brain's activity and to detect abnormalities in its function. They can identify damaged areas in the brain that are focal points for seizures. These tests may be done when surgery is considered to treat difficult-to-control-seizures.
These tests can help to identify metabolic or genetic disorders that may be the cause of seizures. It may also help to identify other causes of seizures such as infections, lead poisoning, anaemia or diabetes.
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