Epilepsy: Which Medical Specialty Should You Consult?

If you suspect you or someone you know has epilepsy, the first point of contact should be a neurologist specializing in epilepsy, typically found in a neurology department. Epilepsy is generally categorized into two types: idiopathic (primary) and symptomatic (secondary). In some cases of idiopathic epilepsy, standard diagnostic tests may not reveal any abnormalities, making diagnosis more complex.

Diagnostic Procedures for Epilepsy

The standard diagnostic tool used in neurology for detecting epilepsy is an electroencephalogram (EEG). This test monitors brain activity and looks for abnormal patterns such as sharp waves or spikes—common indicators of epileptic activity. In addition to EEG, a magnetic resonance imaging (MRI) scan is often performed. MRI helps distinguish between idiopathic and symptomatic epilepsy by detecting structural abnormalities in the brain that could be causing seizures.

Limitations of Current Diagnostic Methods

Despite advances in medical technology, approximately 20% of epilepsy cases may not be detected through EEG or MRI alone. This is because abnormal electrical discharges in the brain do not always appear during testing and can be intermittent. For a more accurate diagnosis, doctors may recommend prolonged EEG monitoring or video EEG telemetry in certain cases.

Treatment and Management of Epilepsy

Once diagnosed, epilepsy is usually managed by specialists in epilepsy care within the neurology field. If a patient experiences more than three seizures per year, medication is typically recommended. Antiepileptic drugs (AEDs) are the most common form of treatment and are usually prescribed for a minimum of three years. It is crucial to maintain consistent medication use and follow medical advice to control seizures effectively.

In addition to taking prescribed medications, patients should undergo regular blood tests to monitor drug levels. These tests help ensure the dosage is sufficient to control seizures without causing toxicity. Based on the blood test results and the patient's overall response to the medication, the treatment plan can be adjusted accordingly for optimal outcomes.