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How Is Epilepsy Diagnosed?

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Updated July 14, 2008

A complete examination for epilepsy is usually performed when you have had your first seizure, or recurrent seizures. Your healthcare provider may ask you many questions concerning the characteristics of your seizure, as well as your complete medical history. Additionally, your healthcare provider will perform multiple tests. These are all important in order to determine whether or not you have epilepsy as well as an appropriate treatment plan. The following procedures will help your healthcare provider determine whether or not you have epilepsy:

A Detailed Medical History

Your healthcare provider will ask you many questions regarding your medical history, including:
  • A list of any drugs you have taken, including prescribed medications and recreational drugs.
  • Any medical conditions you may have been diagnosed with. Some medical conditions may cause seizures to occur.
  • Any chemicals you may have come in contact with.
  • Whether or not you have a family history of epilepsy.
  • Any recent head trauma, infection, or fever.

Characteristics Of Your Seizures

It is also important to tell your healthcare provider what is happening during your seizures and how often they have been occuring. Be sure to also note:
  • Whether there was a loss of consciousness during the seizure.
  • What went on during the seizure? Was your entire body jerking, or one area of the body?
  • What you were doing before they occurred? Be sure to note whether or not you experienced anything before the seizure occurred, like anxiety or purposeless movements.
Since many people don’t remember having a seizure, it might be important to get information from someone who observed you have your seizure.

Blood Tests

Your healthcare provider will also order a blood test in order to make sure that there are no harmful substances present in your body and to check your electrolytes and blood sugar. Poisons and imbalances in your blood sugar or blood chemistry could also precipitate seizures.

Lumbar Puncture

A lumbar puncture is a procedure where a needle is placed in the lower back in order to gather the fluid that surrounds the brain and spinal cord. This is performed if your healthcare provider suspects that you might have an infection in your brain.

Electroencephalogram (EEG)

An EEG measures the electrical activity of the brain by recording from an electrode placed on the head. Seizures are caused by an electrical misfiring somewhere in the brain, and an EEG will help your healthcare provider determine if there is an electrical misfiring in the brain and its location. Additionally, this may be used in conjunction with a video in order to assess the type of seizures you are having.

Brain Imaging

Brain imaging is performed by using special equipment, such as computed topography (CT) scan, positron emission tomography (PET) and magnetic resonance imaging (MRI). Both of these allow your healthcare provider to look at the structure of your brain and will help detect the presence of tumors or other structural abnormalities within the brain. Additionally, PET scans can be used to locate the exact area of misfiring in the brain that is causing your seizures.

Neuropsychological Testing

Neuropsychological testing is used to evaluate memory and cognition.

Source:

Braunwald E, Fauci ES, et al. Harrison’s Principles of Internal Medicine. 16th ed. 2005.

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