Developing the best epilepsy care plan requires an accurate evaluation that identifies the underlying cause of seizures. At Penn Medicine’s Comprehensive Epilepsy Center, we use the latest technology and our deep expertise to bring you a precise epilepsy diagnosis.
How Is Epilepsy Diagnosed?
Having seizures is not enough for an epilepsy diagnosis because not all seizures are caused by epilepsy. In addition, not all episodes that look like seizures are seizures. Careful testing is the only way to be sure you are having recurrent seizures that fit the epilepsy diagnosis criteria.
We begin with a medical consultation and review your:
- Personal medical history and habits
- Family medical history
- Current medications or medication changes
- Current symptoms
- Risk factors for seizures
- Seizure frequency and duration
- Seizure triggers
Based on this information, we recommend specific tests for epilepsy designed to help us look for changes in the brain that could be causing seizures, including:
Electroencephalography (EEG)
Electroencephalograms or electroencephalography (EEG) are tests that detect and record abnormal electrical activity in the brain to determine if seizures are occurring. For people already diagnosed with epilepsy, EEG can provide information about the type of seizures and where they begin in the brain.
Depending on your needs, your doctor may recommend:
- Routine electroencephalography: For this noninvasive test, we paste electrodes or fit a cap with electrodes over your head. Electrodes detect electrical activity occurring in the brain. They connect to a computer that measures and records this activity.
- Ambulatory electroencephalography: Ambulatory EEG is similar to routine EEG. But instead of having brain activity recorded in the hospital, you go home for 24 to 72 hours. Your brain activity is recorded as you go about your regular activities. You carry a small recording device with you to capture the data.
- Magnetoencephalography (MEG): MEG scans record magnetic fields in the brain produced by electrical activity. Mapping this activity can help locate the source of seizures.
- Video EEG: This type of EEG is combined with video monitoring that happens over several nights to capture video and EEG recordings of seizures as they occur.
Brain Imaging
Imaging of the brain allows doctors to look at the brain for physical evidence of epileptic seizures such as scars or lesions. Some types of imaging also allow us to see how the brain performs during tasks and monitor blood flow. Depending on your symptoms, your doctor may order:
- Magnetic resonance imaging (MRI): MRI creates detailed pictures of the brain that doctors can use to look for causes of seizures. At Penn, we use advanced high-field 3T MRI and ultra-high-field 7T MRI, which provide the highest resolution available.
- Functional MRI (fMRI): Functional MRI visualizes the brain while you are resting or performing a task.
- Positron emission tomography (PET): PET scans measure how quickly the brain absorbs a radioactive substance called a tracer. Areas of the brain that do not absorb the tracer as expected may be the location of seizures.
- Single photon emission computed tomography (SPECT): SPECT scans also use radioactive tracers to measure blood flow in the brain to show where seizures are happening.
Inpatient Epilepsy Monitoring
Penn Medicine’s state-of-the-art Epilepsy Monitoring Unit (EMU) is an advanced inpatient facility that allows round-the-clock EEG testing and video monitoring in a safe and comfortable environment.
Genetic Testing for Epilepsy
Some forms of epilepsy arise from genetic changes. These changes may be inherited or occur spontaneously before a person is born. If your symptoms or family history indicate a genetic cause of epilepsy, we may recommend genetic testing with a blood or saliva sample.
Neurological Tests for Epilepsy
Because seizure activity can impact brain function, your doctor may do other tests to look for changes in your brain and guide your epilepsy treatment plan.
- Neuropsychological assessment: These tests assess whether seizures are affecting memory, attention, learning, language, and behavior.
- Visual field assessment: The visual field is the total area you can see. Seizures may cause problems with vision, including visual field loss on the sides (peripheral vision) and middle (central vision) of your visual field.
- Wada test: This test provides information about which side of the brain controls speech and language. We inject a medication that briefly shuts down one side of the brain and then give you speech and memory tests. We also use the Wada test to determine if a person is an eligible candidate for some epilepsy surgeries.
Make an Appointment
Please call 800-789-7366 or make an appointment.