From the Guidelines
Neurologists and epileptologists are the primary healthcare providers who specialize in diagnosing and treating seizure-like activity. These physicians have extensive training in disorders of the nervous system, including epilepsy and other seizure disorders 1. For more complex cases, patients may be referred to epileptologists, who are neurologists with additional specialized training specifically in epilepsy management. The evaluation typically involves a detailed medical history, neurological examination, and diagnostic tests such as electroencephalogram (EEG), which records brain wave patterns, and brain imaging studies like MRI.
Some key points to consider when evaluating and managing seizure-like activity include:
- The definition of status epilepticus, which is a life-threatening form of seizure that can be defined as a seizure lasting longer than 5 minutes or multiple seizures without a return to neurologic baseline 1
- The importance of identifying and treating underlying causes of seizures, such as electrolyte disturbances, withdrawal, toxins, infections, central nervous system (CNS) mass lesions, or other etiologies 1
- The use of anticonvulsant medications, such as levetiracetam (Keppra), lamotrigine (Lamictal), or carbamazepine (Tegretol), to stabilize electrical activity in the brain and prevent seizures 1
In emergency situations, emergency physicians may also play a critical role in evaluating and managing patients with seizure-like activity, particularly in cases where patients present to the emergency department with seizures or status epilepticus 1. However, for ongoing management and treatment of seizure disorders, neurologists and epileptologists are typically the primary healthcare providers involved.
From the Research
Healthcare Providers Specializing in Seizure-Like Activity
The following healthcare providers specialize in seizure-like activity:
- Neurologists: They are specialists in the diagnosis, treatment, and management of neurological disorders, including epilepsy and seizure disorders 2.
- Epileptologists: They are neurologists who have advanced training in the diagnosis and treatment of epilepsy and seizure disorders 2.
- Primary Care Physicians (PCPs): They play a significant role in the care of patients with seizures, although they may not be aware of newer diagnostic and therapeutic measures 2.
- Specialists in epilepsy: They constitute an important resource to ensure that patients are correctly diagnosed and adequately treated 2.
Key Considerations
When it comes to the treatment of seizure-like activity:
- The diagnosis and treatment of seizures and epilepsy require specialized knowledge 3, 2.
- The choice of medication varies depending on the seizure type 4.
- Alternative treatments, such as surgical resection of the seizure focus, ketogenic diets, vagus nerve stimulators, and implantable brain neurostimulators, may be considered for patients with seizures that are not controlled with medication 4.