Health and Social CareEpilepsy – Diagnostic Procedures

Aims and ObjectivesThis session will look at the

procedures for diagnosing epilepsyBy the end of the session you will

have an understanding of these procedures

You will demonstrate your understanding in an end of session assessment

IntroductionEpilepsy is a neurological condition

(a physical condition that starts in the brain)

Epilepsy is used to describe the condition where a person experiences recurrent seizures due to a momentary disturbance in the electrochemical activity in the brain

SeizuresMany people will have a single

seizure at some time in their livesThis does not mean that they have

epilepsy If a person has epilepsy it means

they have had more than one seizure

Diagnosis (General)Diagnosis is mainly based on:The person’s health historyWhat the person describes about

the “events” “Eye witness” accounts of people

who have seen the “events”

Diagnosis (General)Various tests, including EEG

(where brain activity is recorded) may help in the decision making process, but there is not a definitive diagnostic test

Epilepsy can be very difficult to diagnose

Initial RoutesNormally the GP would

make an initial referral to a specialist if epilepsy is suspected

The specialist (epileptologist) could be a neurologist, clinical pharmacologist, psychiatrist or general physician

Eye Witnesses It helps if the specialist can speak

to someone who saw the eventThat person should attend the

appointment wherever possible

Early DiagnosisAn early and accurate diagnosis is

important to: Enable people to come to terms with the

diagnosis Ensure appropriate treatment and support Enable appropriate information to be given

on epilepsy, lifestyle and risk reductionPromote prospects for best quality of life

Testing For EpilepsyThere is no single test to confirm

or rule out a diagnosis of epilepsyThe various tests are a tool to

formulating a complete pictureMost tests are conducted in a

hospital setting

EEG (Electroencephalography)

An EEG traces the brain’s electrical activity and can identify disruptions

An EEG is the most frequently used test

It takes up to an hour

Pain free

MRI scan (magnetic resonance imaging)

An MRI uses magnetic fields and radio waves to scan the brain in a non-invasive way to identify very small lesions and scars

It is very useful in cases where surgery is a possibility

CT or CAT scan (computer-assisted tomography)

X-rays of the brain are taken, providing a series of cross-sectional images

These can then be reconstructed by computer into a 3-dimensional image

Sometimes a dye is injected into a vein to enhance images and highlight suspected areas of brain damage

Other Types of EEGAmbulatory EEGThe person wears a tape cassette

recorder to provide up to several days’ and nights’ recording of the brain’s electrical activity

Video telemetryThis consists of simultaneous EEG

recording of the brain’s electrical activity and video recording of seizures

Other ScansPET scan Non-invasive process (30/60 minutes)

and EEGCreates 3-dimensional images of the

brain and analyses glucose in the brainSPECT scan Similar process to a PET scan taking 20

minutes and highlights “hot spots” of seizure activity

End of Session Assessment

Testing your knowledge. . . . . . .

Before the handout

ReferencesRichards, J. (1999) – Complete A –

Z Health & Social Care Handbook. London. Hodder & Stoughton.

Waugh, A., Grant, A. (2002) – Anatomy and Physiology in Health and Illness. Edinburgh. Churchill Livingstone.

Epilepsy Research Foundation (www.erf.org.uk)