Epilepsy: Diagnostic Tests

Obligatory medical device diagnostics.

  • Encephalogram (EEG; recording of electrical activity of the brain) – provides information about electrical brain activity; for first-time epileptic seizure.
    • [generalized epilepsy: typical generalized spike-wave activity;
    • [focal epilepsy: interictal focal discharges.
    • Combined generalized and focal epilepsy: in interictal EEG typically generalized spike waves and focal discharges on]
  • Magnetic resonance imaging of the skull (cranial MRI, cranial MRI, or cMRI) [epileptogenic lesion?]
  • Computed tomography of the skull (cranial CT, cranial CT or cCT) – high radiation exposure; for first-ever epileptic seizure to determine the exact cause; cMRI is superior to cCT in most cases.

Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.

Further notes

  • In children with a first seizure without a known trigger, a cranial CT showed about a fourfold increased rate for abnormalities if the children had a history of tumor disease, coagulopathy (blood clotting disorder), apoplexy (stroke), heart defect, or sickle cell disease (sickle cell anemia). In focally dominated seizures, they found about a two- to two-and-a-half-fold increased rate of abnormalities.
  • Ictal magnetoencephalography (MEG), i.e . epilepsy during MEG, leads to better seizure localization, i.e. more precise detection of the epilepsy focus.