Epilepsy and its diagnostic methods
Epilepsy is one of the most common chronic neurological diseases. It affects 1% of the world’s population, but in developed countries of 1 million people, there will be 5,000 people with epilepsy and 500 new cases each year, what means more than 10 000 in epilepsy patients in Latvia. Physiologically, epilepsy is characterized by a pathology of central nervous system to develop epileptic seizures due to excessive cerebral cortical neuronal activity, to be determined by a variety of mechanisms in the level of cells and correlation between them. Epilepsy is not a uniform disease, but rather a group of diseases, which may have different formation mechanisms, for example, epilepsy can develop because of congenital neuronal ion channel abnormalities, as well as because of genetic disorders, brain structural development impairment, infection, damage, stroke and alcohol exposure. Epilepsy may develop brain tumors, therefore special attention should be paid to the diagnosis of epilepsy in adulthood, as it is known, that epilepsy is more common in children, less in young people, and its incidence begins to increase with age again, caused by serious structural brain or vascular disease. In most cases the exact cause of epilepsy, each specific to an individual, can not be ascertained, however, early investigations should be conducted to rule out preventable, but potentially dangerous disease causes.
Well – known symptom of epilepsy is a generalized tonic – clonic seizures, in everyday language called seizures. However, epilepsy can have different manifestations or seizure types. For example, so – called absence seizures may occur with a temporary stoppage of consciousness, during which the person ceases to communicate, ceases to take any action, but do not fall. There are no seizures in such cases and person does not remember such absence seizures. Partial motor seizures may also occur as cramps on one side of body, during which consciousness is not lost. Sensory seizures may manifest as sight, hearing, taste, olfactory hallucinations. Somatosensory attacks are manifested as transient sensory changes on one side of the body. Autonomic seizures may manifest as pallor, sweating, flushing and palpitations, nausea, transient episodes of sudden abdominal pain. These are just some of the patient’s potential seizure types. Every individual has a relatively permanent seizure type, which together with electroencephalography findings, etiology, neurological status and the prognosis is characterized by epileptic syndrome.
Taking into account the diversity of epilepsy, multiple illnesses and symptoms that may be confused with epilepsy, a wide differential diagnosis is necessary in a case of epilepsy. Epilepsy may have similar manifestations such as psychogenic disorder (pseudoepilepsy), somatoform disorders, syncope, sweating, transient ischemic attacks, parasomnia (sleep disorders), transient global amnesia, migraine; movement disorders (paroxysmal choreoathetosis, dystonia, tics). Neurologists specializing in treatment of epilepsy are diagnosing this disease. Eelectroencephalography (EEG) and magnetic resonance imaging (MRI) in non-acute circumstances are required by diagnostic standards to diagnose epilepsy.