- The EPC investigations.
| Investigation | Description and rationale |
|---|---|
| Basic blood tests (glucose, electrolytes, liver function tests, renal function tests, ESR, CRP) | To rule out electrolyte imbalances, liver or kidney dysfunction, or signs of infection. |
| Electroencephalogram (EEG) and video EEG | To characterize and confirm the origin of seizures and the concordance with imaging changes. Also, to gauge management outcome. |
| Magnetic resonance imaging (MRI) brain | To evaluate and follow brain structural changes. |
| Magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) | In cases with suspected stroke, cerebral-venous sinuses thrombosis or suspected vasculitis. |
| Magnetic resonance spectroscopy (MRS) | In cases presenting with a clinical picture of mitochondrial disease |
| Cerebrospinal fluid (CSF) (autoimmune markers) | Autoimmune encephalitis panel of antibodies (e.g. NMDA, LGI1, GAD and GABA antibodies) |
| Cerebrospinal fluid (CSF) (cultures) | Routine CSF culture including HSV and consider measles antibody testing if clinically indicated |
| Aminoacids, organic acids, lactate | To screen for metabolic disorders |
| Genetic (WES/WGS) | Whole exome sequencing and whole genome sequencing in idiopathic EPC |
| PET (positron emission tomography) brain or body | To identify the abnormal functional focus if EEG and MRI data were non-concordant. Whole body Pet scan can be considered in cases of possible brain metastatic disease |
| Single-photon emission computerized tomography (SPECT) | To identify the abnormal functional focus if EEG and MRI data were non-concordant. Also, to confirm concordance with other investigations. |
| Brain biopsy | In rare cases, a brain biopsy may be necessary |