§ A diagnosis of epilepsy is usually based on.
§ clinical description of the seizure.
§ a thorough patient history.
§ a complete physical assessment, including results of
laboratory and diagnostic tests.For an acute first seizure evaluated in the ED,
laboratory tests should include a complete blood cell count and an electrolyte
panel.
§ 23 Other tests routinely performed when a patient presents
to an ED for seizure evaluation include a toxicology screening.
§ In febrile patients who are disoriented or display impaired
consciousness, or in afebrile patients who are immunocompromised, lumbar
puncture may be performed to rule out infections such as meningitis or
encephalitis as the root cause of the seizure. In addition, an EEG should be
ordered to assist in determining seizure type, possible epilepsy syndrome, and
treatment management decisions.
§ A normal EEG does not rule out epilepsy, nor does an
abnormal EEG necessarily establish epilepsy, although seizure recurrence is
more likely in patients with epileptiform abnormalities on an EEG.
Website: http://www.arjonline.org/journals
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