The diagnosis and evaluation of Epilepsy requires the physician to know all about the seizures – when they started, the patient’s appearance before, during, and after a seizure, and any unusual behavioral occurrences. A background of the family’s health history is also useful. In addition, an electroencephalogram (EEG) may help detect areas of increased nerve cell activity.
A person is considered to have epilepsy if they meet any of the following conditions:
- At least two unprovoked (or reflex) seizures occuring greater than 24 hours apart.
- One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occuring over the next 10 years.
- Diagnosis of an Epilepsy Syndrome
- Epilepsy is considered to be resolved for individuals who had an age-dependent Epilepsy Syndrome but are now past the applicable age or those who have remained seizure free for the last 10 years, with no seizure medicines for the last 5 years.
What types of doctors can diagnose and treat Epilepsy?
Any licensed physician is qualified to treat Epilepsy. There are doctors who specialize in neurological conditions, and these neurologists can be found practicing in many hospitals and private practices. Epileptologists, Epilepsy specialists, may work in an Epilepsy clinic, as well as in private practices. Usually a referral is required from another physician in order to see a Neurologists and Epileptologists.
Often, the first doctor to diagnose Epilepsy is the family doctor. Most of them have had some experience with it, and will be the one to refer a person with Epilepsy to a specialist initially. Paediatricians are also well aware of Epilepsy. A neurologist has specialized training in the conditions of the brain and nervous system. A neurosurgeon, psychiatrist, or psychologist may also get involved if the circumstances require them.
Can a person with Epilepsy have a false negative EEG?
An EEG measures the electrical activity on the surface of the brain. An EEG may appear to be normal if the abnormal electrical activity is occurring deeper in the brain than the EEG is able to monitor.
Can a person have a false positive EEG for Epilepsy?
Many people who do not have Epilepsy may have some “epileptiform” activity on an EEG. However, this does not prove that they have a seizure disorder. Reading EEG’s is a highly skilled activity, and a diagnosis of Epilepsy is based on the clinical picture as well as the EEG. Other tests, such as CT scans and MRI scans, may be performed to confirm any findings.
Is my child having absence seizures or just day dreaming?
A child having an absence seizure may appear to the onlooker as if they are day dreaming or just staring into space. What may be happening is a sudden period of altered consciousness. To be able to tell the difference, close observations might have to be done. Usual behavioral characteristics of an absence seizure may include: eye blinking, chewing of the mouth, and perhaps a slight rhythmic movement of the facial muscles, head, or arms. During the seizure the child may not respond to verbal or physical stimulation. Immediately after the seizure, the child is able to resume normal activity. If you observe unusual behavior in your child, a visit to a neurologist should be arranged through your family doctor.
What conditions are sometimes misdiagnosed as Epilepsy?
Seizures occurring as a result of alcohol withdrawal, fever, or hypoglycemia can be mistaken for epilepsy. Other causes of seizures that do not indicate Epilepsy are strokes, migraine headaches, calcified blood vessels, narcolepsy, and psychogenic or pseudo-seizures.
Can seizures go unnoticed?
The symptoms of seizures are not always noticeable for on-lookers or for the person who is experiencing the seizure. Seizure may result in rigidity in the body, convulsions, chewing of the mouth, unusual behaviors, or loss of consciousness. Some symptoms may be less apparent, such as disorientation or unusual sensations. Milder symptoms do not mean that the seizure is of less importance.