Epilepsy diagnostic study of choice

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

There is no single diagnostic study of choice for the diagnosis of epilepsy, but epilepsy can be diagnosed based on history, symptoms and physical examination of a patient with seizure complain. Among the patients who present with clinical signs of seizure, the EEG is the most efficient test for diagnosis. Video-EEG monitoring is a combination of recording EEG and clinical behavior of the patient. Although it’s more expensive, it is more effective in differentiating different type if seizures. With the first seizure, we should perform laboratory study, imaging study (MRI, CT Scan), EEG, video-EEG monitoring and Lumbar puncture.

Diagnostic Study of Choice

Study of choice

There is no single diagnostic study of choice for the diagnosis of epilepsy, but epilepsy can be diagnosed based on history, symptoms and physical examination of a patient with seizure complain.^[1]
Among the patients who present with clinical signs of seizure, the EEG is the most efficient test for diagnosis.
Video-EEG monitoring is a combination of recording EEG and clinical behavior of the patient. Although it’s more expensive, it is more effective in differentiating different type if seizures.^[2]

With the first seizure, in order to reach a diagnosis and find out the etiology of seizure, we should perform ancillary testing such as:
- Laboratory study including:^[3]
  - Electrolytes
  - Glucose
  - Calcium
  - Magnesium
  - Complete blood count
  - Renal function tests
  - Liver function tests
  - Urinalysis
  - Toxicology screens
- Imaging study including:^[1]
  - MRI
  - CT Scan
- EEG
- Video-EEG monitoring
- Lumbar puncture^[4]

References

↑ ^1.0 ^1.1 Mattle, Heinrich (2017). Fundamentals of neurology : an illustrated guide. Stuttgart New York: Thieme. ISBN 9783131364524.
↑ Worrell GA, Lagerlund TD, Buchhalter JR (September 2002). “Role and limitations of routine and ambulatory scalp electroencephalography in diagnosing and managing seizures”. Mayo Clin. Proc. 77 (9): 991–8. doi:10.4065/77.9.991. PMID 12233935.
↑ Krumholz A, Wiebe S, Gronseth G, Shinnar S, Levisohn P, Ting T, Hopp J, Shafer P, Morris H, Seiden L, Barkley G, French J (November 2007). “Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society”. Neurology. 69 (21): 1996–2007. doi:10.1212/01.wnl.0000285084.93652.43. PMID 18025394.
↑ Krumholz A, Wiebe S, Gronseth G, Shinnar S, Levisohn P, Ting T, Hopp J, Shafer P, Morris H, Seiden L, Barkley G, French J (November 2007). “Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society”. Neurology. 69 (21): 1996–2007. doi:10.1212/01.wnl.0000285084.93652.43. PMID 18025394.

Template:WH Template:WS

[:0-1] 1.0 ^1.1 Mattle, Heinrich (2017). Fundamentals of neurology : an illustrated guide. Stuttgart New York: Thieme. ISBN 9783131364524.

[pmid12233935-2] Worrell GA, Lagerlund TD, Buchhalter JR (September 2002). “Role and limitations of routine and ambulatory scalp electroencephalography in diagnosing and managing seizures”. Mayo Clin. Proc. 77 (9): 991–8. doi:10.4065/77.9.991. PMID 12233935.

[pmid18025394-3] Krumholz A, Wiebe S, Gronseth G, Shinnar S, Levisohn P, Ting T, Hopp J, Shafer P, Morris H, Seiden L, Barkley G, French J (November 2007). “Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society”. Neurology. 69 (21): 1996–2007. doi:10.1212/01.wnl.0000285084.93652.43. PMID 18025394.

[pmid180253942-4] Krumholz A, Wiebe S, Gronseth G, Shinnar S, Levisohn P, Ting T, Hopp J, Shafer P, Morris H, Seiden L, Barkley G, French J (November 2007). “Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society”. Neurology. 69 (21): 1996–2007. doi:10.1212/01.wnl.0000285084.93652.43. PMID 18025394.

[1]

[2]

[3]

[4]