An epileptologist is a doctor who diagnoses and treats epilepsy and paroxysmal disorders.
Epileptology is a highly specialized branch of neuroscience, which studies the treatment of epilepsy as a disease.
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- Who is an epileptologist?
- When is it necessary to come for a consultation with an epileptologist?
- How is an appointment with an epileptologist going?
- Diagnostic methods used by an epileptologist
- Appointment with an epileptologist
Who is an epileptologist?
An epileptologist is a doctor who has received a specialty in the profession of a neurologist (less often a psychiatrist) and additional education with in-depth study:
- Methods for visualizing the structure, biochemical parameters and functioning of the brain;
- Paroxysmal disorder disorders;
- Human genetic characteristics;
- Methods and methods of social rehabilitation of patients with epilepsy;
- Pharmacology of drugs used for the treatment of epilepsy, etc.
Such a versatile training of specialists is necessary for the doctor to be able to work with patients with severe and rare forms of epilepsy.
In addition, there are pediatric epilepotologists with even narrower specializations. The fact is that the treatment of this disease in childhood is different from the treatment of epilepsy in adults. This applies, first of all, to the selection of medications.
The epileptologist pursues in his work the goal of saving the patient from seizures forever, or reducing the number of their occurrence to a minimum. At the same time, it is necessary to correctly select a drug and determine its dosage. This can take several months.
Epileptologists can practice in specialized hospitals, clinics, and epileptological centers. Specialists accept seriously ill patients in large scientific centers, where departments equipped for the treatment of such patients are located. It is also possible to perform surgical intervention there, if necessary. However, most often patients need long-term outpatient treatment under the supervision of a competent specialist.
If there is no epileptologist in the village, then the patients should be monitored by a neurologist.
Read more: Epilepsy in adults - causes, signs and symptoms of epilepsy, consequences
When is it necessary to come for a consultation with an epileptologist?
As a rule, patients come to a consultation with an epileptologist from another specialist. Most often it is either a neurologist or a therapist. Patients who have experienced an attack of loss more than once, or have been impaired during the attack, must necessarily see an epileptologist.
It should be understood that the attacks of the disease are not always accompanied by loss of consciousness or severe seizures. Sometimes they can be invisible to others and the patient himself. These are the so-called absences. They are often interpreted as excessive absent-mindedness of a person, since they can be expressed in monotonous actions, for example, in chewing movements, in stopping speech. In this case, the patient himself does not pay attention to such attacks. Therefore, if relatives have noticed similar manifestations in their loved ones, the person must be taken to an epileptologist for a consultation. This must be done as quickly as possible.
Often, epileptic seizures are symptoms of a tumor, cyst, or brain abscess. They can occur as a result of traumatic brain injury or during the acute phase of a stroke (see also: stroke - causes, types, signs and consequences).
How is an appointment with an epileptologist going?
During the appointment, the doctor will question the patient in detail about his seizures. The doctor will be interested in their duration, frequency and nature of the course. It is important whether the patient experiences an aura before the onset of an attack, if so, then it is necessary to describe how it manifests itself.
The time of the onset of the first attack and its relationship with certain events and diseases are important. The history of the development of the disease will also be of interest to the epileptologist at the first appointment. In order to provide the doctor with the most complete information, it is best to take with you all the available documentation regarding the disease. It is important to inform the doctor about the facts of epilepsy in the next of kin, if any.
After the interview is completed, the doctor will proceed to the next stage of counseling. This will be a neurological examination of the patient. Its purpose is to identify neurological symptoms in a patient who has come to an appointment. If neurological symptoms are found, then this is evidence that epileptic seizures are associated with organic brain damage.
However, it is impossible to fully identify and confirm the diagnosis of epilepsy without the patient undergoing instrumental examination. Therefore, the doctor will without fail send the patient for additional diagnostics.
Diagnostic methods used by an epileptologist
Among the possible examination methods that the epileptologist recommends to his patients are the following:
- Electroencephalogenetic examination or EEG for short;
- EEG with provocative tests, or EEG during sleep (if the standard EEG is not enough);
- Video EEG;
- The use of methods of provocation is sleep deprivation, hyperventilation and photostimulation;
- Daily monitoring of EEG;
- Brain mapping, which allows you to identify the location of the focus of pathological activity;
MRI of the brain, allowing to exclude tumors, cysts, hamartomas, angiomas, dysplasia of the cortex and other foci of inflammation.
If a patient has a mass in the brain, then he is shown a consultation with a neurosurgeon. In addition to the results of instrumental examinations.
The doctor will need data from some laboratory tests, including:
- Research of liver enzymes;
- Tests for total and direct bilirubin;
- LDH, etc.
When the diagnosis is made and the non-epileptic nature of the seizures is completely ruled out, the doctor will prescribe treatment with anticonvulsants. Their choice is based on the type of seizures, the diagnosed form of epilepsy. If the diagnosis is made incorrectly, then this can only aggravate the patient's condition, since he will begin to take potent drugs that are unsuitable for him. Therefore, only a qualified epileptologist can treat patients with epilepsy. He is also responsible for monitoring the patient's condition during the received therapy.