We conduct standard neurologic tests, including:
• Electroencephalography (EEG): EEG or "brain wave test" evaluates brain function and can pinpoint the location of seizures in the brain based on the presence or absence of abnormal brain waves. This is a short test lasting from 20 minutes to one hour. Often times this is the first screening test. We frequently use EEG paired with video in the hospital for extended periods to diagnose complex seizure disorders.
• Ambulatory Electroencephalography: We also offer ambulatory EEG testing, in which the patient wears an EEG recorder that is slightly larger than a portable cassette player and collects up to 24 hours of brain activity while the patient goes through his or her regular daily activities, permitting examination of brain activity throughout the patient's day.
• Video-EEG monitoring: This test has emerged as the "gold standard" for the diagnosis of complex seizure disorders. The procedure requires a stay in the hospital for up to one week. During video-EEG monitoring, the patient wears an EEG transmitter connected to a wall outlet by a cable. He or she can move about and carry out normal activities, such as talking, reading, and watching television. Ceiling-mounted video cameras continuously record the patient's behavior. The EEG and video signals are synchronized and displayed simultaneously for observation by a physician. Inpatient monitoring also allows for observation of the patient during a full night's sleep, increasing the possibility of recording epileptic activity and other nighttime events. Data generated by this test improves diagnostic certainty and can be very helpful in making treatment decisions, including the choice of the right antiseizure medication and candidacy for epilepsy surgery.
• Magnetic resonance imaging: MRI uses radio waves and a magnetic field to create detailed images of specific parts of the body, including the brain and nerves. A brain MRI is a high-resolution study that can identify the smallest of structural abnormalities and provides much more detail than a screening CT scan.
Specialized Testing
In addition to these standard tests, the Weill Cornell Medicine Epilepsy Center offers more specialized testing that can further help define the seizure focus or provide insight into a patient's baseline cognitive or "thinking" function. These tests include:
• Intracranial EEG monitoring: This test is helpful for patients who may benefit from epilepsy surgery. Through a small operation, EEG electrodes (called "intracranial monitoring devices") are placed on the surface lining the brain, or even deeper in the brain by expertly trained neurosurgeons. By having seizure-recording devices much closer to the source, the point where seizures begin can be very precisely located.
• Neuropsychological testing: Epilepsy often affects memory and brain functioning. This test analyzes a patient's strengths and weaknesses in language, memory, concentration, as well as motor, visual-spatial, and other mental skills. Information gathered from this test can be helpful in determining a person's baseline mental functioning and is often used in conjunction with other testing to assess pre-surgical "mental fitness".
• PET Scan: This type of specialty scanning uses a sugar or glucose intravenous tracer to create brain imaging. Often times the area of seizure onset will be less metabolically active and have a unique pattern on imaging. This type of testing is most often used in patients preparing for epilepsy surgery.