Confirming the Diagnosis of Epilepsy
The first questions we need to answer is whether the patient has epileptic seizures, has seizures that are not epileptic or has something that only looks like a seizure but is in fact something totally different.
If it is not an epileptic seizure, what else could be?
• Seizures that are not epileptic, also called non-epileptic seizures
• Episodes that look like seizures
Why is it so important to make this distinction?
• Many patients that come to an epilepsy center already diagnosed with epilepsy and taking anti epileptic medication, do not actually have epileptic seizures. It is estimated that 2 to 3 out of 10 patients referred to an epilepsy center do not have epilepsy.
• The treatment is very different and the consequences of a wrong diagnosis could be devastating
How do we confirm that the diagnosis is epilepsy and not something else?
• Even though the medical history, physical exam and routine testing give us very useful information, we may still need to perform video-EEG monitoring to confirm the diagnosis of epilepsy. In patients who have epilepsy, we will be able to see electrical discharges during the seizure, while in patients with non-epileptic seizures, the EEG will not show epileptiform activity (electrical changes).