Epilepsy is a tendency to have recurring seizures. There are many different types of seizures but they are always due to abnormal electrical activity somewhere in the brain. Many people will have one seizure at some stage in their lives, but this is not necessarily epilepsy because there is a low risk of recurrence. Many children with epilepsy will eventually ‘grow out of it’ by the time they reach adulthood. For some people, the tendency to recurrent seizures may be a lifelong predisposition.
Epilepsy is one of the oldest conditions known and is described in ancient literature thousands of years ago – including the Bible. In ancient times, seizures were attributed to many causes and influences which we now know are entirely incorrect. Modern scientific research of the brain in epilepsy tells us that seizures are simply the symptoms of an abnormality of the electrical connections in the brain.
Sometimes, the seizures are one symptom within a constellation of symptoms and signs and may follow a distinct and recognized pattern. We call these epileptic syndromes. Many syndromes are benign and easily controlled; sometimes the person will grow out of it. Some syndromes are more severe and can be challenging.
Syndromes are identified by the type of seizure/s, the age at onset, the EEG pattern, the pattern the seizures follow and they are sometimes associated with other underlying conditions. Identifying a seizure syndrome may be useful as sometimes this allows the most appropriate medication to be prescribed.
How is epilepsy diagnosed?
There are many stages in the diagnostic process. It is extremely important to get a correct diagnosis and this may need lots of tests and may take considerable time.
- Is it epilepsy or is it something else?
- If it is epilepsy, what sort of epilepsy is it?
- Where does it start in the brain?
- Is there any structural abnormality in the brain?
What is needed for correct diagnosis?
- a full clinical history and a good description of the seizure/s;
- a physical and neurological examination;
- investigations may include an EEG recording and a CT scan or MRI brain scan.