Health and Social Care Epilepsy – Diagnostic Procedures
Aims and Objectives This session will look at the procedures for diagnosing epilepsy By the end of the session you will have an understanding of these procedures You will demonstrate your understanding in an end of session assessment
Introduction Epilepsy is a neurological condition (a physical condition that starts in the brain) ď Ź 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 ď Ź
Seizures Many people will have a single seizure at some time in their lives ď Ź This does not mean that they have epilepsy ď Ź If a person has epilepsy it means they have had more than one seizure ď Ź
Diagnosis (General) Diagnosis is mainly based on: The person’s health history What 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 ď Ź Epilepsy can be very difficult to diagnose ď Ź
Initial Routes Normally the GP would make an initial referral to a specialist if epilepsy is suspected ď Ź The specialist (epileptologist) could be a neurologist, clinical pharmacologist, psychiatrist or general physician ď Ź
Eye Witnesses It helps if the specialist can speak to someone who saw the event ď Ź That person should attend the appointment wherever possible ď Ź
Early Diagnosis An 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 reduction Promote prospects for best quality of life
Testing For Epilepsy There is no single test to confirm or rule out a diagnosis of epilepsy The various tests are a tool to formulating a complete picture Most 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 noninvasive way to identify very small lesions and scars ď Ź It is very useful in cases where surgery is a possibility ď Ź
CT or CAT scan (computerassisted 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 EEG Ambulatory EEG The person wears a tape cassette recorder to provide up to several days’ and nights’ recording of the brain’s electrical activity Video telemetry This consists of simultaneous EEG recording of the brain’s electrical activity and video recording of seizures
Other Scans
PET scan
Non-invasive process (30/60 minutes) and EEG
Creates 3-dimensional images of the brain and analyses glucose in the brain
SPECT scan
Similar process to a PET scan taking 20 minutes and highlights “hot spots” of seizure activity
End of Session Assessment ď Ź
Testing your knowledge. . . . . . .
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Before the handout
References Richards, 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)