Focus On with Dr. Ahmed Sadek: Diagnosing Epilepsy
Epilepsy is a chronic neurological disorder defined by two or more recurrent unprovoked seizures, meaning the seizures were not triggered by an external cause (drugs, alcohol, low blood sugar etc.). Keep in mind, not all seizures are convulsive—they can vary widely in presentation and may only involve brief lapses in awareness or subtle movements of the mouth or extremities.
The typical “workup” for epilepsy involves blood work, evaluation of medical and family history, a detailed neurological exam, brain imaging, and EEGs.
An EEG (electroencephalogram) is a very important test to help diagnosis epilepsy. This painless test involves placing electrodes on the scalp in order to look at the electrical activity in the brain. If “epileptiform abnormalities” are seen on the EEG, this can indicate a tendency for seizures. However, it is also quite common for people with epilepsy to have a normal EEG; in fact, this occurs in as high as half of patients with epilepsy. A “normal” EEG does not always rule out epilepsy as a diagnosis; in these situations continuous EEG monitoring may be helpful. Sometimes a neurologist may recommend an evaluation at an epilepsy monitoring unit (EMU). This involves a video EEG over a period of several days in an effort to capture the patient’s typical events on video and EEG and to assess more thoroughly for “epileptiform abnormalities.” Although time intensive, this can be an invaluable test for ensuring accurate diagnosis and the most ideal treatment.
If you are concerned about epilepsy, consider seeing an epileptologist and bring the following to your first visit:
- Description of the seizures. A witness account or video recording are most ideal.
- Diary describing the seizures including frequency, description, triggers, etc.
- List of current medications including supplements
- Recent blood work
- MRI images on a CD
- List of any family members with known seizures. In adults, it is helpful to ask parents about any childhood or febrile seizures.
Dr. Ahmed Sadek
Orlando Epilepsy Center, Inc.
Dr. Sadek is the Director of Orlando Epilepsy Center. He is an Assistant Professor of Neurology at the University of Central Florida College of Medicine and a Clinical Assistant Professor of Neurology at the University of Florida Shands, Gainesville. Dr. Sadek is triple Board certified in Neurology, Clinical Neurophysiology, and Epilepsy.