Diagnosing epilepsy involves several steps. The goal is to schedule all of the needed appointments to make an accurate diagnosis to create a customized treatment plan. If testing allows a neurologist to figure out what is causing seizures, it puts patients one step closer to improving their quality of life.
What type of testing is involved?
An EEG is the most commonly ordered test when seizures begin occurring in otherwise healthy individuals. It involves placing sensors directly on a patient’s scalp to record electrical activity in the brain. This may be ordered for 30 minutes in a clinical setting, or a stay in what is called the Epilepsy Monitoring Unit (EMU) at a hospital. A neurologist may ask you stay overnight or multiple nights to monitor brain activity. Most EMU’s also have a video component. Patients are monitored via video to capture any possible seizures to gauge how a patient’s body reacts to abnormal brain activity. Patients are permitted to have a family member in the room. Specially trained nurses and staff provide a safe environment to see to the needs and comfort of each patient and their family.
Magnetic Resonance Imaging (MRI)
This type of imaging allows your doctors to see the structure of a patient’s brain. An MRI reveals different types of lesions that could be causing seizures, such as brains scars due to a head concussion or a stroke, tumors, abnormal blood vessels or areas of abnormal brain development (dysplasias). The imaging involves the patient lying down on a table inside an MRI tube, which is like a tunnel. This type of imaging takes place inside a hospital.
The MEG works by detecting magnetic fields created by electrical activity within a patient’s brain. Special sensors with a “helmet” help detect small magnetic signals produced by the brain. This helps to localize the area of the brain that is causing seizures.
Positron emission tomography (PET scan)
This type of imaging provides information regarding oxygen and sugar (glucose) consumption in the brain. For this type of imaging, a specialist may inject a safe dose of a radioactive substance in the patient’s arm and it will travel to the brain. The radioactive substance is made of glucose marked with a specific compound that will make it visible in the brain. Areas of increased or decreased usage of sugar may help to identify the area where seizures arise.
Achieving a Diagnosis
After reviewing test results, a neurologist will meet with a patient to explain everything in detail and confirm whether they have epilepsy. You can have seizures and not have epilepsy. It’s important to ask questions as patients and doctors work together to provide evidenced-based approaches to treatment plans.