The doctor seldom gets to see you have an actual spell, so the
information provided by you and your family members or other witnesses
is extremely important. No matter how accurate and complete the
information, however, some episodes are difficult to diagnose
correctly, even for experts.
The most obvious clues that separate epilepsy from other
conditions are if the seizures keep recurring (comes and goes), are
intermittent in between spells, the patient is normal and stereotypical
(patient has the same type of symptoms every time). After each spell,
the patient usually feels confused, drowsy and has a headache.
As you are often not aware or cannot remember what has
happened, doctors will turn to the your family or caregiver to give a
detailed description of the seizures.
The first and most important part of a visit to the doctor is an interview, called
taking a history.
The doctor will ask for a complete description of what happened. Often
it is important to bring along a family member or someone else who saw
the seizure and can tell the doctor what happened, since you who had
the spell may have been unconscious. Even if you think that you were
aware, there may be important aspects of the spell that are not
recalled. The doctor will want to hear not only a description of the
seizure itself, but also the story of the events leading up to it and
the aftereffects that followed it.
The doctor will examine you and some specialist tests may be
carried out. These may help to find a cause and also to tell which type
of epilepsy you have. Not everyone needs all of the tests described
here, your doctor will decide which ones you need. The doctor may have
enough information on the first visit for treatment to be recommended
and started, but sometimes this will happen only after further test
results are reviewed.
The doctor then will thoroughly examine the person and
probably will order several tests. The doctor may have enough
information on the first visit for treatment to be recommended and
started, but sometimes this will happen only after further test results
are reviewed.
What tests and investigations are carried out?
EEG (Electroencephalogram)
Small recording electrodes are attached to the head, which record
the electrical activity of the brain. The recording is printed onto
paper. This test is usually carried out in a clinic. You will need to
either lie of sit still during this test but it is not painful in any
way. You may have a rapidly flashing light (strobe) shone in your eyes
during the test. However, if there is not seizure activity during the
test, the EEH can loom normal, but you may still have epilepsy. The EEG
is mainly used to classify the type of epilepsy you have, it is rarely
used for diagnosis.
Ambulatory EEG
This is the same sort of test as an EEG, however, the electrodes
are worn over a period of time, A video camera may be used to record
the person’s actions. The aim of this test is to 'catch' the start of a
seizure to see what part of the brain is affected.
CAT scan (Computerised Axial Tomography)
This is a special firm of x-ray, which gives pictures of the brain
as a series of slices. Occasionally, an injection of dye or contrast
may be used. The due or contrast helps to outline and show the
structures of the brain more clearly.
MRI Scan (Magnetic Resonance Imaging)
This is similar to the CAR scan but the pictures are more detailed.
It takes 20 to 30 minutes and involves you lying down inside a scanner.
It can be quite noisy. Again, an injection of a dye or contrast may be
necessary. You will need to lie very still during the test. If you
suffer from claustrophobia, please let the scanning department know in
advance.
