Epilepsy is a common ailment that affects the nervous system of the body. Pathology manifests itself in the form of seizures. Attacks are expressed in violation of consciousness, sensory and motor functions, behavior and emotions. The clinic manifests itself in the form of generalized seizures. Epilepsy is treatable, but the main thing is to make an accurate diagnosis. The thing is that a single seizure is not enough to detect the disease, so a thorough examination will be required. EEG in epilepsy is one of the most effective diagnostic methods that helps to identify the disease quickly and begin treatment.
What is EEG: the essence of the method
An EEG or electroencephalogram is an effective diagnostic method for patients with signs of epilepsy and other various brain injuries. Often this method is prescribed to patients who do not need it at all.
The essence of the technique is that it registers electrical signals supplied by neurons - nerve cells of the brain. In fact, many pathologies are manifested by severe disturbances in the electrical activity of the brain. Most often, this is epilepsy, during which a group of neurons shows serious activity, and structural changes in the brain are detected: tumors, cysts, consequences of stroke and hemorrhages.
This technique is considered as accurate as possible, and all because it can fully show the entire clinical picture of the disease:
- how widespread the inflammation and its level;
- what changes have occurred in the vessels;
- early signs of epilepsy;
- neoplasms and stages of their development;
- how disturbed the brain is due to an ailment affecting the nervous system;
- what are the consequences of a stroke, hemorrhage, or surgery.
According to ICD-10, the code G40 is assigned to epilepsy, a detailed description of the EEG for this pathology allows you to track what changes have occurred in the brain, especially if this study was not the first time. Thus, the doctor has the opportunity to monitor brain activity during treatment and adjust it at any time. Almost always after diagnosis, the doctor can determine exactly where the focus of excitation is localized.
When do I need an EEG?
This diagnostic method is used for various speech, mental and neurological disorders. As a prophylaxis, EEG can be prescribed to people who pass an exam to obtain a driver’s license, as well as to obtain permission to store and carry weapons. Positive results can exclude the presence of schizophrenia and other mental disorders. EEG shows epilepsy, and also gives other data, therefore, for therapeutic purposes, this technique is used:
- after a surgical intervention that could affect the functioning of brain cells;
- in identifying and determining the location of tumor and cystic formations;
- with traumatic brain injuries received in various ways;
- to confirm or disprove the presence of epilepsy;
- if the patient has cramps, numbness of the extremities and fainting;
- with a chronic form of hypertension and a violation of the circadian rhythm;
- if the child has a developmental delay.
EEG of the brain allows you to identify not only violations in the functioning of brain tissue, but also the severity and depth of their damage, the location of the focus of the disease. In some cases, regular monitoring may be recommended, in other words, several studies at short intervals, which will help not only to identify signs of epilepsy on the EEG, but also determine the further treatment, which can be corrected.
When studying the processes of activity of the nervous system, you can prevent another attack. For patients in a coma or under prolonged general anesthesia, this type of diagnosis is mandatory, because it will help determine the working capacity and vital activity of brain tissue.
Research value
The code for epilepsy according to ICD-10 G40, EEG in this disease helps to identify and fix foci of neuron activity. The main aspects of the application of this technique are:
- determination of the form of the disease;
- the ability to track the dynamics of development;
- monitor patient improvement;
- selection of the correct therapy and dosage of drugs.
The main value of the diagnosis is that all pathological changes can be detected between seizures.
If anomalies are present, then the equipment registers peaks and waves, as well as graph elements specific to its determination. Therefore, as soon as flashes of activity, peaks and waves appear on the EEG, this already indicates the presence of a pathological condition, but this is not enough for an accurate diagnosis. Similar changes are often observed in malignant neoplasms, after a stroke, sleep disturbance, encephalopathy. That is why other studies are additionally carried out.
Each form of the disease has its own characteristic waves. With rolandic, a large concentration of them is observed in the central temporal lobes, at night - in the frontal part.
How to prepare for EEG?
After 12 am, the patient should avoid drinking caffeinated drinks before making a diagnosis. The hair should be washed and dried, while you can not apply oils, lotions and aerosols to them. There are no other requirements, but the child needs to be prepared more carefully to get the right results.
An epileptic seizure in a child can begin at any moment and parents are not always ready for it. Therefore, if even the slightest deviations were noticed, you need to seek help and pass an examination. EEG will help to make an accurate diagnosis, but you should prepare for the study:
- Inspect the baby's head well. If wounds and scratches are found, then they should be reported to the doctor. Electrodes cannot be attached to damaged skin.
- Feed the baby. The study is carried out on a full stomach, the only way you can get non-blurred results. But you can’t give sweets with chocolate. Grudnichkov is fed before the procedure in a medical facility. In this case, the baby will fall asleep calmly and will sleep peacefully during the study.
To stop taking medications, if the child receives them on an ongoing basis, then doctors warn about this. Children of school and preschool age need to explain what they will do, only the right psychological attitude will help to avoid excessive emotionality. A child can bring toys, but not electronic ones.
Remove all foreign objects from the head, such as rubber bands and hairpins, the hair should be loose. If the EEG for epilepsy is not the first time, then be sure to bring along the previous transcript. If the child is sick, then the diagnosis is not carried out, they expect his full recovery.
Features of the diagnosis
EEG of the brain is a painless procedure that will not harm either an adult or a child. During the diagnosis, the patient is conveniently located in a chair, electrodes are placed on his head, but initially measurements are taken in three positions: head circumference, distance between the nose bridge and the protrusion of the occipital bone, from one ear to the other through the crown. Only then can one determine exactly where to mount the electrodes. The attachment point is degreased with alcohol, after which the gel is applied and a sensor is installed. In some cases, special helmets or caps may be used.
What does EEG look like in case of epilepsy? Yes, in different ways, even in a healthy person you can sometimes find waves and activity peaks, which is mainly due to its individual characteristics.
In children who suffer from neurosis and psychopathy, as well as those who are aggressive, the study reveals activity, while there are no clinical signs. But in most small patients with such data, epilepsy is diagnosed over time.
With extensive seizures, activity is observed in all areas, and when it is a focal form, it is only in certain areas. It is not always possible to detect signs of the disease in people who abuse alcohol. These patients can cause activity: eye movement, swallowing, touching sensors, contraction of the muscles of the head, heartbeat, pulsation of blood vessels.
The age of the patient, taking pills for epilepsy or other diseases, the time of the last seizure, visual impairment, irregular shape of the skull - all this can affect the results of the EEG. Therefore, the study is carried out taking into account all related factors.
How long does the study take?
A routine examination is a routine EEG or diagnosis of a paroxysmal condition. The duration of the study depends on which site is checked and what functional tests are used. On average, the procedure takes about half an hour. During this time, the specialist manages:
- perform rhythmic photostimulation using different frequencies;
- check hyperventilation;
- hold a load in the form of blinking;
- detect hidden changes.
If the data obtained are insufficient, then in addition to the EEG for epilepsy, a specialist can use a deeper and more effective examination:
- EEG of a night sleep.
- EEG with deprivation.
- Continuous EEG.
The duration of these techniques can take time from 20 minutes to 15 hours.
EEG rhythms
During the EGG, the apparatus reveals four main types of rhythms:
- Alpha waves are the main diagnostic element for a healthy adult patient and are recorded in 90% of people. These waves have a frequency of 13 hertz per second and are fundamental during wakefulness, when the patient simply lies with his eyes closed. The maximum activity of alpha waves is observed in the occiput and tempech region.
- Beta, like alpha waves, is attributed to normal manifestations in the body of a healthy adult. But the number of their oscillations reaches 35 hertz per second, they are recorded mainly above the frontal part. The beta rhythm is manifested if the sensory organs are irritated: touch the patient when stimulated with light or sound.
- Delta waves with a frequency of up to 3 hertz during decoding of the EEG during epilepsy can mean the norm in a baby up to one year. Partially, the indicator persists up to 7 years. In adults, they are fixed during sleep.
- Theta rhythm with a frequency of up to 7 vibrations per second is normally found in children from one year to 6 years old, gradually being replaced by alpha waves as they grow older. In adults, they are observed during sleep.
How do EEG indicators change with age?
In infants in the first months after birth, when decoding the analysis, slow delta and theta waves prevail. But closer to the first year, alpha waves become more active and predominant by 9 years.
The full picture of the EEG, which is characteristic of an adult, is formed by 16 years and remains in a stable state up to 50 years. As the body ages, alpha waves no longer dominate as they did before, and by age 60, normal EEG is the same as in a child’s body.
Decryption analysis
Before answering the question of what to do with epilepsy, you need to accurately decrypt the EEG data. Research data are displayed on a monitor or on paper in the form of graphical curves that can be decoded only by an experienced specialist. The analysis and conclusion of EEG in epilepsy is given by a neurophysiologist, who, when decoding, takes into account the patient’s age, his complaints, the clinical picture of disorders in the body and many other factors, such as heredity.
Decryption Highlights:
- It turns out which of the rhythms is the main, predominant in the patient.
- We carefully study the symmetry of the electrical potentials of nerve cells, which are recorded from the left and right hemispheres of the brain.
- An analysis of pathological changes, for example, delta and theta waves in an adult patient while awake, is carefully carried out.
- The regularity and amplitude of the rhythms is checked.
- Paroxysmal activity is revealed when sharp waves, peaks and sky waves are detected on the curve.
- If there are no pathological changes in the background EEG, then additionally conduct functional tests, such as hyperventilation or photostimulation, re-registration of electrical potentials and interpretation.
What are the changes on the EEG with epilepsy?
During an epileptic seizure, the registration of EEG allows you to record high-amplitude activity in the form of peaks and sharp waves. Out of an attack, convulsive activity in the brain may not be manifested in any way, therefore, in order to provoke epileptic activity, various tests are used. Patients often experience paroxysmal activity in the form of high-voltage theta and delta waves. For long-term registration of the EEG, video monitoring is allowed when the study is conducted over a long period of time, in some cases up to 8 hours, subsequently the specialist decrypts it.
EEG allows not only to determine the location of the focus of the disease, but also to recognize its variety. If, nevertheless, the diagnosis is confirmed and on the graph you can see bright and unlike changes, then the description of the EEG for epilepsy will contain the following information:
- waves with sharp angles, sharply rising and falling;
- pronounced slow waves with sharp corners;
- sharp increase in amplitude by several units;
- during hyperventilation testing, narrowing and severe spasm of the vessels appear;
- during photostimulation, an unusual response to the test is observed.
If there is a suspicion that this is indeed epilepsy, then on a control study the tests are carried out in a sparing mode, and all because the load can cause another epileptic seizure in the patient.
When the diagnosis is accurately established, many wonder what to do with epilepsy, how to help such a patient.
What diagnoses does the EEG still reveal?
After passing the examination, neurologists often diagnose in children and adults not only epilepsy, but also other ailments. Among the common diseases, there are the following:
- neoplasm in the brain of various etiologies, the cause of which is not clarified;
- traumatic brain injury;
- an inflammatory process that simultaneously affects the lining of the brain and the brain substance, an infection can cause this condition;
- abnormal accumulation of fluid in the structures of the brain, often this pathology is congenital, perhaps the pregnant woman did not undergo mandatory screenings or this ailment developed as a result of an injury that the baby received during childbirth;
- a chronic disease that affects the mental and nervous state with characteristic seizures - epilepsy, heredity, birth injuries, infections, and maternal misbehavior during pregnancy can become provoking factors;
- cerebral hemorrhage due to rupture of blood vessels, the condition can provoke high blood pressure, head injuries, blockage of blood vessels by cholesterol plaques;
- Cerebral palsy;
- sleepwalking, somnambulism.
A lot of diseases can be detected, therefore, if suddenly the EEG does not show epilepsy, but there are seizures, the doctor prescribes other types of studies. This is the only way to exclude other pathologies and make a more accurate diagnosis.
Epilepsy treatment
If a person has convulsive seizures, then first of all it is necessary to seek the advice of a doctor, only he can prescribe a comprehensive examination and select the therapy. First of all, the patient is prescribed to undergo an EEG, and here many patients ask themselves whether epilepsy is always active. Other diseases affecting the nervous system can show activity on the EEG, so it is important that the decryption is carried out by a doctor who accurately recognizes the signs of a particular disease.
Epilepsy is a chronic pathology that has been studied for more than a dozen years. It is impossible to accurately answer the question of whether epilepsy is inherited, acquired due to extraneous factors, or is it a malfunction at the genetic level that occurred in the womb.
But one thing can be said, it is impossible to cure the disease, you can only achieve a stable remission, if you choose the right treatment regimen. Cases were recorded when patients with timely treatment started showed significant improvement and attacks for a long time did not make themselves felt or passed without harm to the person.
Treatment is based on the fact that the patient is constantly taking pills for epilepsy. If the patient has partial seizures, then such drugs are used:
- Valproates, including Valparin, Convulex, Depakin Chrono.
- Derivatives of carboxamide: Timonil, Finlepsin, Zeptol.
- Phenobarbital: Luminal.
- Phenytoinovy means: "Diphenin".
The treatment regimen for each person is selected individually depending on his condition and form of the disease:
- It is more convenient to use drugs that have a long-term effect. They are taken 1 or 2 times a day.
- If the patient loses consciousness during the attack, then in addition to the main treatment, Ethosuximide is recommended.
- New drugs such as Tiagabin and Lamotrigine have proven their effect in practice. Therefore, patients have been prescribed them lately.
It is definitely impossible to answer the main question of interest to many patients who have a disease, whether epilepsy is inherited. In some patients, after a survey in the family, relatives with such an ailment were identified, while others did not. There are concomitant factors that play a role and provoke the development of the disease, even in those who have no relatives in the family with this disease.
It is important to pay attention to your symptoms and relatives at the right time, to seek help, then you can avoid the consequences and aggravation of the condition.