Why an accurate diagnosis is needed before treating epilepsy

  Epilepsy is not terrible, but epilepsy is a special category of diseases that often require rational longer-term pharmacological or surgical treatment. Therefore, before treatment begins, it is important to clarify whether epilepsy is present (distinguished from syncope, diabetes, blood disorders, eclampsia, TIA, hysteria, etc.), as well as the cause, specific subtypes, and severity of epilepsy to avoid misdiagnosis and mistreatment.  Outpatient EEG generally records only 5-20 minutes of brain waves, and 24-hour dynamic EEG has only 8-12 scalp recording electrodes, which has limited information and rarely records seizures, and even if a seizure is recorded, it is difficult to record the whole process, and the seizure process stated by the family often differs greatly from the facts, which often misleads the doctor’s diagnosis. The most valuable diagnostic test is the long-range video EEG, which can simultaneously record the subtle changes of EEG and action video, and the computer dynamically analyzes the EEG characteristics of the patient at each stage of wakefulness, thoughtful sleep, light sleep, deep sleep, dreaming, and waking up. This will determine which of the dozens of types of epilepsy the patient belongs to, and formulate a targeted drug treatment plan.  MRI of the brain is also important, but unlike brain tumors and brain hemorrhage, in most cases epilepsy only has abnormalities in the fine structures of the brain, which are often undetectable with ordinary equipment. For patients with basically clear epileptogenic foci and poor drug efficacy, surgery can be carefully considered. At this time, PETCT examination of the brain is also needed to further confirm the location of the epileptogenic foci and to understand the possible brain function damage caused by surgery and avoid it as much as possible.