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
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
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.
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.
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.
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.
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
Patricia E. Penovich, MD, Minnesota Epilepsy Group