Epilepsy

Tests

Laboratory and non-laboratory tests are used to diagnose and monitor epilepsy, to determine what kind(s) of seizures the patient is having, to identify underlying conditions such as toxins, infections, drug or alcohol withdrawal, fever (in a child), or diabetes that may be causing seizures, and to distinguish epilepsy from conditions such as fainting or a stroke that may cause some of the same symptoms.

A medical history, input from the patient, and input from family members who have witnessed a patient’s seizures are important parts of the diagnostic process. The patient may remember a strange smell, an aura, and/or sensations that precede a seizure but may not remember what has happened during the seizure itself. Depending upon the signs and frequency of a person’s seizures, it may take some time to determine the proper diagnosis.

Laboratory Tests
Laboratory tests are primarily used to monitor anti-epileptic medications and to rule out other conditions such as diabetes, anemia, infection, meningitis or encephalitis. Testing may include:

Periodic therapeutic drug monitoring when a patient is taking a specific medication, such as:

• Carbamazepine
• Phenytoin
• Valproic acid
• Phenobarbital

Other testing:

• CBC (Complete Blood Count) – to evaluate red and white blood cells
• Glucose – may be increased or decreased with diabetes
• CSF analysis – to check for infection and help diagnose meningitis and encephalitis
• Blood culture – to check for septicemia, infection in the blood

Non-Laboratory Tests

• Electroencephalogram (EEG) – a primary diagnostic tool for epilepsy; it is used to evaluate the brain’s electrical activity and identify changes in brain wave patterns.

Imaging scans:

• Computerized tomography (CT) – identify brain structure abnormalities and tumors
• Magnetic resonance imaging (MRI) – also identify brain abnormalities
• Positron emission tomography (PET) – radioactive material is used to look at active areas of the brain.
• Single-photon emission computerized tomography (SPECT) – radioactive material is used to identify the region of the brain where seizures originate when it is not clear on other scans.