Talking about epilepsy diagnosis

  1. Relevant medical history: A detailed and accurate seizure history is particularly important for diagnosis. Seizures should have these characteristics of seizure and repetition. If the seizure is epileptiform, note the seizure onset, seizure performance, seizure duration, state of consciousness during seizure, and correlation with sleep. The triggers of each seizure. Personal and past history related to brain injury, such as perinatal abnormalities, motor and intellectual development, and history of craniosynostosis and trauma, is also needed. Family history of epilepsy, psychiatric disorders and genetic metabolism is also important for a definitive diagnosis of epilepsy.  Physical examination: especially signs related to brain diseases, such as head circumference, mental retardation, paresis, cone bundle signs and various neurocutaneous syndromes (such as skin café-au-lait, depigmented spots, fibromas, hemangiomas, etc.) 3. The positive rate of EEG in patients with epilepsy is only 30%-40%. In order to improve the positive rate of EEG, the EEG recording time should be extended according to the patient’s condition, and special evoked tests such as sleep deprivation and hyperventilation can be designed to improve the positive rate. Therefore, epilepsy cannot be excluded based on the absence of epileptiform discharge waveforms on the EEG.