What Is Epilepsy?
Epilepsy is a condition in which a person has seizures that affect one, or several, of their physical and mental functions. According to the Epilepsy Foundation of America, a patient is diagnosed with epilepsy when he has had two or more qualifying seizures. A seizure is when a strong current of electrical activity takes place in part of the brain. Normally, the cells send electrical impulses through the brain in an orderly fashion. These impulses control functions such as movement or speech. A seizure occurs when the cells send the impulses all at once, which is what causes the loss of motor control. Seizures can involve many symptoms, from convulsions, to blank stares, to twitching, to periods of unconsciousness. Seizures are not always a result of epilepsy. They can stem from other conditions as well, such as infection or high fever.
Obtaining Medical History
When a patient sees a doctor because of seizures, the first thing the doctor will do is interview the patient about their medical history. The New York University Comprehensive Epilepsy Center claims that obtaining a complete medical history on a patient is the most essential tool in making a proper diagnosis. Relaying accurate information to the doctor is critical, as he is not able to witness the seizures. He will need to be given as much detail about the seizure as possible, such as the time of day of the seizure, how it began, any stressful situations in the patient's life, prescription or over-the counter drug use, recreational drug use, the position of the patient when the seizure happened, what sort of movements the patient's body made during the seizure, how long the seizure lasted and the patient's level of alertness post-seizure. NYU Epilepsy Center even recommends videotaping the seizures if the patient has them often enough.
EEG Testing
Often the first set of tests run are blood tests. These will help rule out, or confirm, other medical problems the patient may have, such as kidney or liver disease. Once the blood work is out of the way, the next step is often an electroencephalogram (EEG) that measures the brain's electrical activity. Cedars-Sinai Medical Center states that the EEG is the most important test when diagnosing epilepsy. With several electrodes attached to the head, brain waves are measured after various stimuli are exposed to the patient. Some of these include making the patient breathe rapidly into a bag to see if hyperventilating may induce epileptic seizures, and exposing the patient to bright light to check for seizures in response to light sensitivity. The doctor will also check brain waves when the patient is awake and asleep.
Brain Imaging Tests
There are several different tests that fall under the category of "brain imaging." The Epilepsy Foundation of America lists angiograms, MRIs and CT scans as the most common.
An angiogram is performed by injecting dye into the blood vessels that go to the brain, and then taking x-rays of the brain. This test can help locate any abnormality of the brain that may be responsible for the seizures, such as a blood clot or a tumor.
A magnetic resonance image (MRI) records pictures of the brain by measuring magnetic fields within the brain. An magnetoencephalogram (MEG) can show the doctor exactly what part of the brains the seizure signals are coming from. A computerized tomography (CT) scan is another test that provides pictures of the structure of the brain.
According to the NYU Comprehensive Epilepsy Center, all of these imaging tests can point out abnormalities such as brain tumors, scar tissues and atrophy of the brain.
The Diagnosis
Once the tests have been run and the doctor has read them, a diagnosis can be given regarding epilepsy. If she finds conclusive evidence that the seizures are a result of epilepsy, there are several different treatment options. According to the Mayo Clinic, some treatment options available include surgery, medication, nerve stimulation and deep brain stimulation. The option the doctor chooses will be based on the severity of the patient's epilepsy.
