At the Pediatric Epilepsy Center, we use several testing methods to diagnose epilepsy in children. Your child's neurologist will discuss testing recommendations with you based on your child's symptoms and history.

Your child's neurologist may order blood tests to look for signs of infection, genetic abnormalities or other conditions that could cause seizures.

What is an EEG?

EEG is the name commonly used for electroencephalography. EEG is the most important test for diagnosing epilepsy, because it records the electrical activity of the brain. It is safe and painless. Electrodes (small, metal, cup-shaped disks) are attached to your child’s scalp and connected by wires to an electrical box. These wires can only record electrical activity. They do not deliver any electrical current to your child’s scalp. The box is then connected to the EEG machine.

The EEG machine records the brain’s electrical activity as a series of squiggles called traces. Each trace corresponds to a different region of the brain. EEGs used to be recorded on paper, but we now use computerized, paperless EEGs.

It takes about an hour to complete a routine EEG study, and your child can go home afterward. We also perform longer outpatient EEGs that last from 24 to 48 hours.

 

What is a video EEG (VEEG)?

With VEEG, your child is videotaped while the EEG is recorded. The recording is usually carried out over several days. The doctor usually views the video and EEG images side-by-side on a split screen. This way, your child's doctor can see exactly how your child’s behavior during seizures is related to the electrical activity in his or her brain.

Because your child is in the hospital under close supervision, we allow them to have some seizures, which our experts can study. The doctor may reduce or even stop seizure medicines to make seizures more likely. Other techniques include sleep deprivation, hyperventilation (very rapid or deep breathing) and exercise.

VEEG is most helpful in determining whether seizures with unusual features are actually epilepsy, identifying the type of seizures and pinpointing the region of the brain where seizures begin. Locating the region precisely is essential if epilepsy surgery is being considered.

If we believe surgery is an option for your child, we may recommend a Wada test. A Wada test is performed by a neuroradiologist while a neuropsychologist and a neurologist are present. The Wada test helps doctors determine which side of the brain controls memory and language. This is important information for surgeons to know because it can help them minimize the risks of language and memory deficits after surgery. The neuropsychologist takes part in the testing process because he or she can help assess your child’s cognitive functions, mood and personality.

Part of your child’s evaluation will likely include neuroimaging studies, which help us closely observe the structure and functions of your child's brain.

Tests include:

  • Computed tomography (CT)
  • Functional MRI (fMRI)
  • High-resolution brain magnetic resonance imaging (MRI)
  • Intraoperative MRI
  • Magnetic resonance spectroscopy (MRS)
  • Positron emission tomography (PET)
  • Single photon emission computed tomography (SPECT)
Many children who have epilepsy may also have other medical conditions, such as depression or anxiety. They may also have cognitive impairments, such as poor memory or difficulty concentrating. Part of our evaluation often includes partnering with a neuropsychologist to assess your child's cognitive functions mood and personality.
A lumbar puncture, commonly called a spinal tap, may help your child's neurologist determine the source of their seizures. Learn more about this procedure and what to expect if your child is going to have one.

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Child Epilepsy