How to make Diagnosis of Epilepsy

       To be able to diagnose a person with epilepsy can be done through anamnesis and clinical examination with EEG and radiological examination. However, if by chance saw the attack in progress, then epilepsy (clinical) can already be enforced.

1. Anamnesis
      Anamnesis must be done carefully and detailed, because the examiner almost never witnessed the attacks experienced by patients. Explanation about everything that happened before, during and after the attack (including symptoms and duration of the attack) is very meaningful information and diagnosis is the key. History also brought information about head trauma with loss of consciousness, meningitis, encephalitis, metabolic disorders, vascular malformations and certain drugs.
Anamnessi (auto and aloanamnesis), includes:
- Pattern / shape attack
- Duration of attack
- Symptoms before, during and after the attack
- Frequency of attacks
- Trigger factors
- The presence or absence, another disease that affects now
- The age of patients at first attack
- History of pregnancy, childbirth and development
- History of the disease, the cause, and previous therapy
- History of epilepsy in the family

2. General physical and neurological examination

       See any signs of a disorder associated with epilepsy, such as head trauma, ear or sinus infections, congenital disorders, focal or diffuse neurologic disorders. Physical examination should be dismissed causes of attacks using the age and history of the disease as a handle. In children, the examiner must consider the presence of developmental delay, organomegaly, the difference in size between the limbs may indicate early unilateral brain growth disorders.
3. Neuroimaging
a. Electro-encephalography (EEG).
       EEG examination should be performed on all patients with epilepsy and an investigation is most often done for rnenegakkan diagnosis of epilepsy. However, EEG is not the gold standard for diagnosis. EEG results is said to be meaningful if supported by clinical. Focal abnormalities on EEG shows the possibility of a structural lesion in the brain, while the common abnormalities on EEG shows a possible genetic or metabolic abnormalities.
EEG recordings said to be abnormal.
1) Asymmetric rhythm and voltage waveform in the same area in both hemispheres of the brain.
2) Rhythm irregular waves, wave rhythm is slower than it should eg delta waves.
3) The waves are usually not found in normal children, such as sharp waves, spikes, and slow waves  paroximally arising.
b. EEG video recording 
       EEG recordings and video simultaneously in a patient who was having an attack can increase the accuracy of diagnosis and location of the attack source. EEG video recording showing the relationship between clinical and EEG phenomena, as well as provide an opportunity to repeat the clinical picture there. Expensive procedure is very useful for patients whose cause is not known with certainty, and also beneficial for cases of refractory epilepsy. Determination of partial epileptic focus location by this procedure is necessary in preparation for surgery.
c. Radiological examination
       Examination known as neuroimaging aims to look at the structure of the brain and EEG data supplement. When compared with the CT Scan MRI is more sensitive and will look more detailed anatomic. MRI is useful to compare the right and left hippocampus
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