Epilepsy is known to be a neurological condition that impacts the lives of millions of individuals across the world but is unfortunately poorly understood. In most people, epilepsy brings to mind clichéd images of seizures or brief loss of consciousness. In some cases, both might be included. However, epilepsy is a complex syndrome with varied symptoms and etiologies. It is essential to educate families, patients, and caregivers about the symptoms and signs, the diagnostic process, and the nature of the testing required to make them more knowledgeable and more prepared against the condition.
What Are the Signs and Symptoms of Epilepsy?
The previous telltale sign of epilepsy is recurrent unprovoked seizures. However, all seizures are not equal. The appearance of epilepsy is often quite similar among patients as well as among seizures in an individual.
Other people report what the rest of us would call a seizure. This may include jerking, spasmodic arm and leg movements, loss of consciousness, and occasional loss of bladder or bowel control. These are known for tonic-clonic or “grand mal” seizures. Most people with epilepsy, however, have much milder symptoms. For example, absence seizures show when an individual, usually a child, blankly stares for some seconds, with minimal smacking of lips and eyelids, and then returns to normal activity with no memory of the attack.
Seizures can also manifest as unexpected or sudden muscle contractions, temporary confusion lasting a few minutes, unexplained phenomena (electric shock sensation, unusual smell, or sense of déjà vu), or sudden change in mood (fearfulness or elation). Some individuals have an aura, a pre-seizure warning that alerts them that a seizure is unavoidable. An aura may even lead to an individual losing the ability to speak or becoming confused or tired for a few minutes after a seizure.
It is important to remember that not every strange movement or activity is a seizure, and not everyone who has a seizure has epilepsy. Seizures are caused by fever, low blood sugar, and other illnesses. Epilepsy is not diagnosed until someone has two or more seizures that are not due to some immediate cause.
How Is Epilepsy Diagnosed?
Diagnosis begins with a complete history and account of what occurred. Doctors may ask about what occurs before, during, and after the seizures and will even have the individual who witnessed the event narrate what occurred. They will also ask if there were any possible reasons, such as sleep deprivation, stress, or strobe lights.
The healthcare professional may suggest a neurologic checkup to understand certain functions, such as motor function, reflexes, mental status, and behavior. Laboratory testing is occasionally performed to exclude infection, metabolic illness, or genetic illness responsible for the seizures. Diagnoses of epilepsy are usually made by doctors when an individual has had two or more unprovoked seizures or when a test shows a high probability of future seizures. Since seizures may be similar to other illnesses, such as fainting, migraine, or hypoglycemia, there might be a requirement for stringent evaluation.
What Are the Tests Used to Diagnose Epilepsy?
Tests used to diagnose epilepsy’s cause and type are most beneficial when they include the electroencephalogram (EEG). This test records the electrical brain activity with electrodes on the scalp. Epileptiform discharges, or abnormal patterns, may be revealed even in an individual who does not have seizures. In specific situations, only a normal EEG will be required, but long-term or ambulatory EEGs (worn 24-72 hours) will identify abnormal activity that may not appear. The EEG can be recorded while awake and asleep, and sometimes following sleep deprivation, in order to obtain the greatest return in detection of abnormalities.
Imaging examinations are also used. Magnetic resonance imaging (MRI) captures images of brain structure and can identify lesions, tumors, or congenital abnormalities causing seizures. A CT scan can be employed in an emergency department or in centers where an MRI is not available to identify bleeding, a tumor, or a stroke.
In this more complicated case, other procedures can be performed. PET (Positron Emission Tomography) or SPECT (Single Photon Emission Computed Tomography) scans can be performed to assess brain function or the etiology of the seizures. Genetic testing can be requested if an inherited epilepsy syndrome is being considered. Physicians also employ video EEG monitoring to observe seizures in action, which can be employed to distinguish epilepsy from other disorders and establish the type of seizure.
Why Early Diagnosis Is Crucial?
Early and proper diagnosis of epilepsy is very important. It will allow us to act in time, preventing further seizures and enhancing the quality of life. The majority of epilepsy patients can conquer seizures and lead active, productive lives, provided they are properly treated. If you experience inexplicable attacks of confusion, staring, or other movement disorders, don’t hesitate to see a doctor.