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Diagnosing epilepsy

  • It is important to be evaluated by a doctor even if an individual has experienced just one seizure.  Seizures can cause injury and even death, or they can be a symptom of an underlying problem with the brain. The doctor will try to determine if a seizure has occurred and whether or not treatment is needed to prevent more seizures. 

    There are several kinds of tests or assessments that will help the doctor to determine if the individual had a seizure and if he or she needs treatment to prevent further seizures. Some of the assessment may include:

    Medical history

    The doctor will want to know specific details about the seizure. This information is helpful in determining the cause of the seizure and if the patient has epilepsy. Bringing someone that has witnessed the seizure to the appointment can be very helpful. 

    Neurological examination

    A neurological examination is a detailed exam that helps the doctor evaluate how the brain and nervous system are working. The exam is not invasive and does not hurt. The doctor will do things like check reflexes with a reflex hammer, check the eyes with a light, assess the patient’s walking and balance, and ask questions that assess the patient’s ability to think, concentrate and speak.

    EEG

    An electroencephalogram, or EEG, is a painless test that measures the electrical activity of the brain. For the test, small electrodes are placed on the patient’s scalp to record the electrical activity of the brain. The doctor will interpret the EEG and look for any abnormalities that may signal there is risk for more seizures, or whether there may be another condition or problem with the brain. 

    MRI

    Magnetic Resonance Imaging, or MRI, is a test that produces pictures of the brain. MRI produces detailed pictures of the brain’s anatomy or structures. These pictures can be helpful in determining the cause of epilepsy. MRI is painless and does not expose patients to X-rays or radiation. 

    Patients should inform their doctor if they have an allergy to contrast or dye prior to the MRI. They should also let the doctor know if they are not able to lie still or feel anxious in small spaces, as they may need a medication to help them relax during the MRI.

    Other neuroimaging

    There are other imaging studies that look at the how the brain functions or works. These are generally done for patients that are being evaluated for epilepsy surgery.  They include PET (positron emission tomography), MEG or MSI (magnetoencephalography or magnetic source imaging) and SPECT (single photon emission computed tomography).

  • Reviewed by: Patricia E. Penovich, MD, Minnesota Epilepsy Group
    First published: 04/04/2016
    Last reviewed: 03/25/2016

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