Epilepsy is a clinical diagnosis based on a detailed description of events. There is no single test which can always make, or exclude, a diagnosis of epilepsy. Moreover, as also explained in earlier chapters, epilepsy is not a single condition. There are many different types of epilepsy, and there are many different causes of epilepsy. Investigations may be useful to:

• add weight to, or support the clinical diagnosis of epilepsy;

• help ‘classify’ the type of epileptic seizure and epilepsy syndrome. This is important in predicting the likely outcome of the epilepsy in a given individual, and the treatment that should be used; and

• help detect or find a cause for the epilepsy.

The main investigations which may be used in epilepsy are the electroencephalogram (EEG) and brain imaging techniques, most commonly computerized tomographic scanning (CT scanning) or magnetic resonance imaging (MRI). Other investigations such as X-rays, blood tests, lumbar puncture (spinal tap), or tissue biopsy are much less commonly undertaken.

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