Contents
An epileptologist is a doctor who diagnoses and treats epilepsy and paroxysmal disorders.
Epileptology is a highly specialized branch of neurology, which is the object of study of the treatment of epilepsy as a disease.
Find a doctor
What is an epileptologist?
epileptologist is a doctor who has received a specialty by profession a neurologist (less often a psychiatrist) and additional education with in-depth study:
Electrophysiology;
Methods for visualizing the structure, biochemical parameters and functioning of the brain;
Disorders of paroxysmal disorder;
The genetic characteristics of a person;
Methods and ways 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 an even narrower specialization. The fact is that the treatment of this disease in childhood is different from the treatment of epilepsy in adults. This concerns, first of all, the selection of medications.
The epileptologist pursues in his work the goal of saving the patient from seizures forever, or to reduce the number of their occurrence to a minimum. This requires a competent selection of the drug and the determination of its dosage. This may take several months.
Specialists-epileptologists can practice in specialized hospitals, clinics, epileptological centers. Severely ill patients are received by specialists in large scientific centers, where departments equipped for the treatment of such patients are located. It is also possible to perform surgical intervention, 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 locality, then the patients should be observed by a neurologist.
When should I visit an epileptologist?
As a rule, patients get a consultation with an epileptologist on a referral from another specialist. Most often this is either a neurologist or a therapist. Without fail, patients who have experienced an attack of loss more than once, or consciousness was impaired during an attack, must get an appointment with an epileptologist.
It should be understood that 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. At the same time, the patient himself does not pay attention to such attacks. Therefore, if relatives notice similar manifestations in their loved ones, the person must be taken to a consultation with an epileptologist without fail. 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 a traumatic brain injury or during the acute phase of a stroke (read also: stroke – causes, types, signs and consequences).
How is an appointment with an epileptologist?
During the appointment, the doctor will interview 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.
What matters is the time of occurrence of the first attack and its relationship with certain events and diseases. 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 survey 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 the patient who came to the appointment. If neurological symptoms are detected, then this is evidence that epileptic seizures are related to organic brain damage.
However, it is impossible to fully identify and confirm the diagnosis of “epilepsy” without the patient undergoing an instrumental examination. Therefore, the doctor without fail will send the patient for additional diagnostics.
Diagnostic methods used by epileptologists
Among the possible examination methods that an epileptologist recommends to his patients are the following:
Electroencephalological examination or abbreviated – EEG;
EEG with provocative tests, or EEG during sleep (if the standard EEG is not enough);
Video-EEG;
The use of provocation methods is sleep deprivation, hyperventilation and photostimulation;
Daily EEG monitoring;
Mapping of the brain, which allows you to identify the location of the focus of pathological activity;
MRI of the brain, which allows to exclude tumors, cysts, hamartomas, angiomas, cortical dysplasia and other foci of inflammation.
If a patient has a volumetric formation 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:
UAC;
Study of liver enzymes;
Biochemical blood test;
Analyzes for total and direct bilirubin;
LDG 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, on the diagnosed form of epilepsy. If the diagnosis is made incorrectly, then this can only aggravate the patient’s condition, as he will begin to take potent drugs that are inappropriate for him. Therefore, only a qualified epileptologist can treat patients with epilepsy. It is also his duty to monitor the patient’s condition during the therapy received.