Why Epilepsy Patients Need Many Tests

  Persistent status epilepticus is a recurrent seizure that lasts more than 20 minutes (some locate 30 minutes) or has frequent seizures and then one right after another before consciousness never fully returns to normal during the interval. Persistent status epilepticus is generally prone to occur in cases of sudden discontinuation of medication, overstimulation, and rapid change of antiepileptic drugs. Persistent status epilepticus can cause brain tissue hypoxia and enhanced metabolic activity of the body, which can cause failure of multiple organ functions, resulting in permanent brain damage and endangering the patient’s life. If left untreated, cerebral edema, brain herniation, and respiratory and circulatory failure can occur. If the patient is found to have persistent epilepsy, the family should send the patient to the hospital as soon as possible. If available, intravenous Valium can be administered to terminate the status epilepticus as soon as possible. Pay attention to keep the respiratory tract unobstructed, avoid aspiration of foreign bodies, prevent fractures, eliminate precipitating factors, take medication on time, do not suddenly stop or reduce medication, live a regular life, and after the seizure has stopped, adequate amount of antiepileptic agent should be given in time for maintenance treatment to avoid relapse.  Epilepsy is a symptomatic diagnosis, and lesions in almost any part of the brain can lead to seizures. Epilepsy therefore has many types, and each type of epilepsy has a different treatment and prognosis. Especially in patients with intractable epilepsy requiring surgery, the location of the epileptic focus and functional areas of the cerebral cortex also need to be determined. Due to the complexity of epilepsy, there is no method that can accurately and unambiguously suggest the location of the epileptic focus. In most cases MRI and CT can show structural brain changes. PET can suggest the metabolism of brain tissue and functional MRI can suggest the location of functional areas of the cerebral cortex. Intracranial buried electrode EEG helps to determine the location of the epileptic focus more precisely. The combination of multiple tests is therefore essential in the preoperative evaluation of epilepsy.