Seizures and Epilepsy
What Is It?
Seizures are transient symptoms of abnormal neuronal activity. Epilepsy is 2 or more unprovoked seizures or 1 seizure with high recurrence risk. First seizure requires urgent evaluation to identify cause and recurrence risk.
How Is It Diagnosed?
EEG for epileptiform activity. MRI brain. Labs to exclude provoking factors (glucose, sodium, calcium, magnesium, BUN, tox screen, alcohol). LP if CNS infection suspected.
How Is It Treated?
Anti-seizure medications (ASMs): levetiracetam, valproate, lamotrigine, lacosamide - chosen by seizure type and patient factors. Focal epilepsy with refractory disease: surgical evaluation. Vagus nerve stimulator. Neurology referral required.
Tests and Imaging Typically Needed
EEG, MRI brain, CBC, BMP, glucose, tox screen, AED levels, LP if indicated, genetic testing for some epilepsy syndromes.
Approximate Self-Pay Costs
Office visit: $95-$150. EEG: $200-$500. MRI brain: $500-$1,200. Levetiracetam: $10-$30/month. Neurology required.