Research is vital to redress our lack of understanding of epilepsy and its causes, as this could lead to earlier diagnosis and possibly even prevention.

Epilepsy can be difficult to diagnose as other conditions often cause similar symptoms.

Early and accurate diagnosis is essential to ensure that appropriate treatment pathways are selected.

Despite technological advances the diagnosis of epilepsy still depends on an expert interpretation of a patient’s history. The time has come to use advances in computer technology and automatic speech analysis to support the decision-making process with artificial intelligence systems.
Professor Markus Reuber, grant awardee

Epilepsy is usually diagnosed following at least two seizures occurring more than 24 hours apart. A GP makes a referral to a specialist neurologist who will use patient and witness accounts to develop a history. It is then likely that there will be a range of investigations conducted to help form a complete picture of the situation. Most of these will take place in a hospital but not everyone will need all of them to get a correct diagnosis.

Brain trace showing epileptic activity

To read more about the research we are funding to achieve earlier diagnosis through the automation of patient history recording and analysis click here

Some of the most common diagnostic tools for epilepsy are as follows:

The EEG measures the brain’s electrical activity via electrodes placed on the scalp. It is non-invasive, takes place in hospital, is pain free and normally takes about an hour. However an EEG is often completely normal in people later diagnosed with epilepsy so methods such as flashing lights, or sleep deprivation are sometimes used to try to deliberately provoke abnormal electrical activity in the EEG.

‘Brain trace showing epileptic activity’

Another tool used in the diagnosis of epilepsy is magnetic resonance imaging (MRI). This is another non-invasive and painless way to try to help diagnose epilepsy. It uses magnetic fields and radio waves to penetrate the brain in order to give very detailed scans which will identify small lesions and scars in the brain. It is extremely useful in identifying the location of the seizure activity so is used widely where surgery may be a treatment possibility. Occasionally it may be necessary to inject a dye into the veins to enhance the images. The whole procedure should take about an hour as it requires the patient’s head to be fixed in the scanner at the hospital. For these and other reasons the system is compromised.

This year, 2019, Epilepsy Research UK awarded a grant to Dr Umesh Vivekananda from the Institute of Neurology, University College London, to a project which

aims to develop and use a novel, state-of-the-art form of electrical brain recording called portable Magnetoencephalography. This will likely be able to record abnormal epileptic activity with much greater accuracy, and clarity than present methods, so greatly facilitating the identification of areas of brain region causing the epilepsy. This has the potential to revolutionise the assessment of people for epilepsy brain surgery.

Computerised tomography (CT) scans use X-rays of the brain to provide cross-section images of the brain that are stored on a computer.  Again, sometimes a dye is injected into a vein to improve the images.  Whilst the scan itself will only take about 10 minutes, up to 60 minutes preparation time will be required.

In ambulatory EEG, the person suspected of having epilepsy wears a tape cassette recorder to provide up to several days’ and nights’ recording of the brain’s electrical activity.

Video-EEG telemetry consists of simultaneous EEG recording of the brain’s electrical activity together with video recording of the seizures. It is usually carried out over a few days and is mainly used when the diagnosis is unclear or for assessment for surgery.

A PET scan or positron emission tomography is another non-invasive process that takes up to an hour to complete.  The scan produced is a 3-D image of the brain and uses a tracer to observe and analyse brain function.  This particular test is usually performed between seizures.

And finally, the single photon emission computerised tomography (SPECT) scan. This technique is similar to the PET scan where the most common tracer used measures the blood flow in the brain.  The injection of the dye will typically be done during seizure activity, when video-EEG telemetry is taking place.  The scan which takes about 20 minutes, takes place soon after and highlights ‘hot spots’ of seizure activity. It is typically used when people are being assessed for epilepsy surgery.

Find out more about the diagnosis of epilepsy in this Research Roundtable webinar

Through the incredible efforts of our supporters over the last twelve months, we are delighted that Epilepsy Research UK was able to make over £1.3 million available for our 2021 grant awards.

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