Diagnosis of Epilepsy
The diagnosis of epilepsy involves identifying the cause and type of seizures a person is experiencing. Since epilepsy is not a single condition but a group of disorders, diagnosis requires a detailed medical evaluation and often several tests. An accurate diagnosis is essential to determine the best treatment plan and rule out other conditions.
Medical History and Symptom Review
The first step in diagnosis includes:
A detailed description of the seizure episodes
What happened before, during, and after the seizure
Family history of epilepsy or other neurological conditions
Known head injuries, infections, or developmental delays
Witness accounts can be very helpful, especially if the person having seizures is unable to recall the event clearly.
Physical and Neurological Examination
Doctors perform a full examination to assess brain and nervous system function. This includes checking:
Reflexes
Muscle tone
Balance and coordination
Speech and memory
While the exam might be normal between seizures, it helps rule out other conditions.
Electroencephalogram (EEG)
The EEG is one of the most important tools in diagnosing epilepsy. It measures electrical activity in the brain using small sensors attached to the scalp. Doctors look for unusual patterns that may suggest epilepsy, even if the person is not actively having a seizure during the test.
Sometimes, a sleep-deprived EEG or video EEG monitoring is needed to capture abnormal activity more clearly.
Brain Imaging
MRI scans help detect structural changes in the brain, such as tumours, scarring, or malformations.
CT scans may be used when MRI is not available, although they are less detailed.
Advanced centres may use PET or SPECT scans in complex cases.
Blood Tests
These are used to check for:
Infections or inflammation
Metabolic or genetic disorders
Medication levels (if already on treatment)
Diagnosis of Epilepsy In South Africa
In South Africa, access to EEG and MRI scans may be limited in rural or underfunded areas. As a result, epilepsy is often diagnosed based on symptoms and history alone. Where available, mobile health units and referral systems help connect patients to urban centres with diagnostic equipment.
The diagnosis of epilepsy must be thorough and timely. A clear diagnosis opens the door to proper treatment and long-term management.
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