In order to diagnose and confirm epilepsy, several diagnostic tests are required to be undergone by the patient. The most frequently used test, also considered the diagnostic tool for epilepsy, is a test called electroencephalography. This test reads the persons brain electrical activity. For people with epilepsy, they usually have abnormal brain wave patterns, even at the absence of seizure. However, the test is said to be most accurate if it is taken within the first 24 hours after a seizure attack. When a child without fever is having convulsive seizures, or when an adult has his very first seizure, the test more often commnly used is called brain imaging. CT scan or CAT scan and MRI are tests used to reveal the true brain structure of the person, identifying presence of possible tumors, cysts and other structural abnormalities in the brain, as pictured by the precise images the tests result to. PET scan and functional MRI tests are used to monitor and detect abnormalities in the brain activity of a person with epilepsy. Blood tests may reveal infections, anemia, diabetes and lead poisoning – all linked to seizure attacks. Microscopic examinations are also done for blood analysis. In examining a child, metabolic and genetic screening with the help of a highly powered microscope is done. Other tests like developmental tests, neurological and behavioral tets are also done in diagnosing and monitoring the patient.
In treating an epileptic patient, the key is to determine the type of seizure that he has. Once the diagnosis of an epilepsy has been established, current treatment options can be offered to the patient. These treatment include medications with antiepileptic drugs, vagus nerve stimulation for epilepsy that is not responsive to medications and ketogenic diet which is low in sugar and proteins and high in fat, and lastly neurosurgery. Neurosurgery is an option for seizures that don’t respond to medication therapy. Usually, surgery is not considered until the patient has tried two or three different antiepileptic drugs for a period of time without success. The surgical procedures could be lesionectomy, lobectomy, corpus callosotomy, or hemispherectomy.
Lesionectomy is the surgery most frequently used for seizure patients. It aims to remove a seizure focus in the brain where there is an abnormality, believed to be causing the seizure activity. This areas, or lesions, are removed. This type of surgery is most appropriate for partial type of seizures. Lobectomy takes away a larger focus area of the brain. Temporal lobectomy is most often performed. The temporal lobe of the brain is removed and this usually stops up to about 90 percent occurrence of epileptic seizures.
With corpus callosotomy, the connection between the left hemisphere and the right hemisphere of the brain is done. The connection is surgically cut. This type of surgery is ideal for children whose seizure activiy starts on one side or hemisphere of the brain and spreads on the other. This is helpful in treating generalized and atonic seizures. The last neurosurgical procedure is called hemispherectomy. This procedure involves the removal of half the cortex or outer layer of the brain. This procedure is used as last resort.
