Diagnosis & Treatment

Most cases of epilepsy in the United States are treated by family practitioners, yet family practitioners will see a new case of epilepsy on the average of only once every two years. For this reason patients are often referred to a neurologist, or even better, to a specialized epilepsy center, for definitive treatment.

The diagnosis of epilepsy is based largely on medical history. An EEG is very helpful, but unless the physician actually witnesses the seizures while an EEG is running, the diagnosis could always be in doubt. Ordinarily an evaluation for epilepsy should include a careful history of the patient and his or her family to see if other members of the family have had seizures and what kind; whether there have been other neurological problems or other illness that can cause epilepsy; and a review to see whether any other medicines are being taken.

• A careful description of the seizure is most important. Specific areas of the brain control different bodily functions; a detailed description of the seizure helps to determine what parts of the brain are involved.
• A general physical and neurological examination to look for causes should include testing of specific functions of the central nervous system.
• Blood tests are used to check for such things as infections, disturbances in blood cells, problems in the liver, etc.
• Electroencephalogram (EEG): By measuring the electrical changes that occur normally in the brain, the physician can look for any abnormal discharges or distinctive brainwave patterns that help make the diagnosis.
• Magnetic Resonance Imaging (MRI): Similar to x-ray examinations, but using strong magnetic fields, an MRI is a computer-generated picture of the brain. The pictures are much more detailed than those revealed by X-rays, including CT (computerized tomography) scans.
• Video EEG Monitoring (sometimes inaccurately called telemetry): In specialized epilepsy centers the patient can have an EEG and a video picture recorded simultaneously, which enables a physician to make the definite diagnosis.
• Other special imaging studies, such as PET and SPECT, may be carried out.
• If the patient is thought to be getting too much medicine, or might have extensive brain damage, or if brain surgery is being considered, tests to evaluate various aspects of brain function. Neuropsychological tests may also be performed.

This site is presented for information only and is not intended to substitute for professional medical advice. Use of this site is subject to a disclaimer. Presentation and design ©Copyright 2000 Rev. 2005 MINCEP® Epilepsy Care.
All Rights Reserved.