Diagnosing epilepsy is much like solving a puzzle. The process involves gathering information, ruling out possible causes, and testing. If you have had a seizure and have not been previously diagnosed with epilepsy, it is crucial that you consult with your physician. Often the first step toward a diagnosis is a visit to an emergency room or your general practitioner.
What information should I provide?
Be prepared to give a detailed account of what occurred. If someone close to you witnessed the seizure, consider bringing them to your appointment. At the very least, try to bring reports from witnesses. Since seizures rarely happen on command in the doctor’s office, the following clues can assist your doctor in pinpointing a cause, the kind of seizure, or affected areas in the brain:
- time of day
- position at onset (standing, sitting, laying down)
- activity at onset
- seizure duration
- level of consciousness during seizure
- affect on the body (rhythmic jerking, twitching, falling down)
- areas affected (side of body, parts of body, senses, and emotions)
Your doctor will likely ask you about your family medical history and about events leading up to the seizure. This information will help to determine possible triggers and rule out seizure activity which may be caused by another condition.
- family history
- sleep deprivation or disturbance
- excessive intake of alcohol or other substance
- brain injury
- illness such as an infection
What tests or procedures are used to diagnose epilepsy?
Your doctor will perform a brief neurological examination and order blood tests. Because epilepsy involves the electrical impulses in your brain, your doctor will want to observe your brain’s structure as well as its activity. The two most common of first line tests are painless and noninvasive
An electroencepholography (EEG) is a painless low-risk test that may take place right in your doctor’s office. Via small electrodes applied to your scalp, an EEG machine will record your brain impulses and convert them into waves your doctor can read much like a heart rhythm. From an EEG, your doctor can determine any irregular patterns of activity and their location in your brain.
A magnetic resonance imaging test (MRI) may be ordered to enable your doctor to see a detailed image of your brain’s structure. An MRI is useful in determining whether your seizure may have occurred as a result of a tumor, a stroke, or other tissue abnormality. MRIs can also reveal limitations in bloodflow caused by scar tissue.
What kind of medical professional weighs in on an epilepsy diagnosis?
Following a thorough exam and testing, you may be referred to a neurologist, a doctor who specializes in neurological disorders. A neurologist will diagnose epilepsy and prescribe seizure prevention or anti-seizure medications (AEDs). The National Institutes of Health report that complete control of seizures can be achieved in up to 50% of patients with use of AEDs. If medication fails to suppress seizure activity, you may seek out an epileptologist, a neurologist who specializes in epilepsy and is associated with an epilepsy center. There you’ll have access to surgery and device implant options as well as clinical trials possibilities.
