How Doctors Diagnose Epilepsy
A seizure can be a dramatic and scary event. But just because you or a loved one had a seizure doesn’t mean an epilepsy diagnosis.
If your doctor suspects epilepsy or some other neurological condition, he or she will refer you to a neurologist. Neurologists who specialize in epilepsy are epileptologists.
There are many types of seizures and different forms of epilepsy. Your neurologist will use several methods to evaluate your seizures and diagnose epilepsy. As part of the diagnostic process, your doctor will identify the part of the brain involved and the type of seizures you have.
Your doctor will ask you questions about what the seizure looked like and what happened just before it began. It is important to provide as much detailed information as you can about your seizure. For example, some people have mild staring episodes and others have intense convulsions. Ask a loved one to record your symptoms during a seizure. The information you or witnesses of the seizure can give the doctor is critical to an accurate diagnosis of epilepsy.
In addition to learning about your symptoms, the details of your seizures, and your medical history, your doctor will conduct a series of tests.
Neurological exam. Your doctor will do a complete neurological, behavioral and developmental exam to understand the possible cause of seizures and if the seizures are affecting brain function. These tests include a combination of physical, verbal and written pieces.
EEG. An EEG (electroencephalography) records electrical activity in the brain. An EEG may show abnormal electrical activity in people with epilepsy. However, an EEG may look normal after a seizure and between seizures. It’s possible you may need to wear an EEG device for several days or longer in order to catch abnormal activity. Your doctor may also ask you to stay in the hospital for evaluation and to record brain activity.
Brain scans. CT (computed tomography) or MRI (magnetic resonance imaging) may be used to look for growths, scars, or other conditions in the brain that may be causing your seizures. PET (positron emission tomography) scans may be used to identify areas of the brain that are producing the seizures.
Many other conditions can cause seizures, but it does not mean you have epilepsy. Your doctor may order a series of blood tests and other tests to check for the following:
- Abnormal glucose (sugar) and sodium levels
- Brain infection
- Drug abuse and withdrawal
- Liver and kidney function
- Medication side effect or overdose
- Poisoning such as carbon monoxide
Doctors can usually diagnose epilepsy after at least two seizure episodes and when there is no other known cause, such as low blood sugar or abnormal kidney or liver function. In some cases, your doctor will be able to further identify the cause of epilepsy, such as an infection in the brain or a genetic condition. Unfortunately, in the majority of cases, doctors cannot find a cause. This is also known as idiopathic epilepsy.
Diagnosing epilepsy is challenging and requires a series of physical exams and many tests. It’s difficult to be patient when you are coping with the uncertainty of seizures. Stay in touch with your doctors and let them know how and what you are feeling. There are numerous support groups for epilepsy, including the Epilepsy Foundation.