The main method of diagnosis of epilepsy is electroencephalography (EEG). However, with a single record of EEG in a clinic or in a medical center, usually carried out in the period between attacks, pathological changes are not always detected. This is due to the fact that the probability of an attack at the time of recording the EEG is not high enough. At the same time, some patients (though not all) changes in EEG are detected only during attacks.
Therefore, the most valuable diagnostic method is the long-term recording of EEG. EEG monitoring (long — term EEG recording for several hours, usually during the day) and video EEG monitoring-EEG monitoring in combination with constant video recording, allowing you to get a record of EEG during the attack at the same time with video shooting of the attack). .
It is very important to record EEG during sleep (in some forms of epilepsy, characteristic changes in EEG are detected only in certain phases of sleep).
Long-term video EEG monitoring is the most accurate method of diagnosis of epilepsy. Video EEG monitoring allows not only more accurate diagnosis of epilepsy, but also “track” the results of treatment. After all, sometimes the patient can significantly reduce and disappear attacks, but the monitoring reveals pathological activity, which may indicate in favor of changes in therapy. This is also especially true when deciding on discontinuation of therapy. The decision to discontinue therapy is made in the absence of seizures and epileptiform activity on EEG in most cases within 3-5 years. In addition, there are forms of epilepsy with a high index of epleptiform activity on EEG, especially during sleep; a decrease in this index indicates a positive “response” to therapy.