Can EEG rule out Epilepsy?

[amarendrakalita]

I had an incident of syncope (unconciousness) for few seocnds early morning one day after micturating. EEG was normal. The neurologist said that my normal EEG ruled out epilepsy. Thereafter CT Scan and MRI of the brain was also done. A focal gliotic lesion on the right frontal prasagittal region of the brain has been confirmed with minor prominance of the celebral sulci. The doctor has not assigned any reason for this and said that it was nothing to worry about. I was diagnosied as having micturion syncope and postural hypotension. However, she prescribed treatment for epilepsy in case of ocurance of any further unexplained syncope. I find the prescription a bit confusing considering that she had already said that my normal EEG ruled out epilepsy. Does a normal EEG rules out epilepsy? Should I look for further diagnosis/reason for the gliotic lesion?

[PaulMD]

Hi there.

I understand your concern.  A normal EEG makes the diagnosis of epilepsy unlikely but can never be 100% accurate.  However, I agree with your doctor that this is probably not a seizure disorder.  Other causes to explore includes cardiovascular problems like low blood pressure or metabolic problems such as diabetes or thyroid problems.  The micturition syncope can have a neuropathic component and I believe this may be one reason that your doctor prescribed anti-epilepsy medications (not entirely to address a possible epilepsy problem).  I suggest you discuss the other options with your doctors and that these episodes will not repeat itself.  Regards and God bless.