1 Diagnosis. 2 Most important information: “History, history, history!” Eye witness account and...

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DiagnosisDiagnosis

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Most important Most important information:information:

““History, history, history!”History, history, history!” Eye witness account and persons Eye witness account and persons

own account of event (s)own account of event (s) Medical historyMedical history Family historyFamily history

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A diagnosis of epilepsy is not A diagnosis of epilepsy is not usually made after a one off usually made after a one off or two seizuresor two seizures

It is hard to remove the label of It is hard to remove the label of epilepsy so it is important to be epilepsy so it is important to be cautious when making the diagnosis cautious when making the diagnosis

There are other causes of seizures…..There are other causes of seizures…..

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Differential diagnosisDifferential diagnosis Febrile convulsionsFebrile convulsions FaintsFaints Cardiovascular eventsCardiovascular events MigraineMigraine Metabolic disordersMetabolic disorders Disassociative seizures or non Disassociative seizures or non

epileptic event disorderepileptic event disorderSome people may have both epilepsy Some people may have both epilepsy

and non epileptic seizuresand non epileptic seizures

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None of these conditions will None of these conditions will respond to anti-epileptic respond to anti-epileptic

medication.medication.

In the UK, up to 30% of people In the UK, up to 30% of people referred to specialist epilepsy referred to specialist epilepsy centres do not have epilepsy centres do not have epilepsy which is why their seizures have which is why their seizures have remained uncontrolledremained uncontrolled

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Key questions to askKey questions to ask

What happened prior to the eventWhat happened prior to the event What exactly happened during the What exactly happened during the

eventevent How was the person directly after the How was the person directly after the

eventevent

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Tests to assist with Tests to assist with diagnosisdiagnosis

These are not diagnostic testsThese are not diagnostic tests

Blood tests & ECG to help rule out other Blood tests & ECG to help rule out other causes for the eventscauses for the events

EEG (be aware that people with migraine can EEG (be aware that people with migraine can have abnormal EEGs and that in most cases, have abnormal EEGs and that in most cases, unless the person has a seizure during the test unless the person has a seizure during the test the results will be normal)the results will be normal)

CT scanCT scan

MRI scan MRI scan

Brain scans will not show anything if there is Brain scans will not show anything if there is no structural cause, or if the abnormality is no structural cause, or if the abnormality is very smallvery small

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Err on the side of caution…Err on the side of caution…

If there is doubt about the cause of the If there is doubt about the cause of the events, let time assist you.events, let time assist you.

Ask the person and their family to Ask the person and their family to make close observations of any other make close observations of any other events and to come back.events and to come back.