How is epilepsy diagnosed?

For all my talk of epilepsy, I haven't really discussed how a diagnosis comes to pass.  Through my experiences, I've noticed that a lot of doctors are hesitant to offer up a diagnosis of epilepsy when a person is having seizures.  It seems that the doctor will always look for another medical reason for the seizures to be occurring.  Most of the time, that is the doctor just being thorough in his diagnosis. The doctors honestly don't want to suggest epilepsy if there is another reason why the seizures are occurring.  For example, in children, if the child is experiencing a high fever, then a seizure can often be experienced.  These are called febrile seizures, and in most instances, they're relatively harmless and the child will usually not experience one again. 

When a person experiences two or more seizures without an obvious cause (fevers, result of a head trauma, etc.), then you're facing a diagnosis of epilepsy. 

First the doctor will take a thorough medical history.  You will usually be asked variations of the following questions:

•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.

The doctor will continue by asking what your seizures are like.  This is one of the reasons why it is so very important to document everything you feel before, during, and after.  Have the people that are with you while you are seizing document what you do during a seizure.  TIME IT!!  As I've mentioned before, it helps establish a pattern if you can document everything in relation to before, during and after a seizure. 

You'll have blood tests run.  The doctor is checking for harmful substances in your blood, your blood sugar, electrolytes, etc.  Be ready for them to take several tubes. 

Next step would be to have an electroencephalogram (EEG).  You will have sensors attached to your head that will measure brain activity in all the areas of the brain.  Each sensor will measure sections of electrical activity in the brain.  If there is any abnormal brain activity, then an EEG will find it.  As a side note, it is completely normal to have a normal EEG, but still have a diagnosis of epilepsy.  My daughter has had hundreds of seizures, but with the exception of two or three EEGs taken immediately after seizure activity, all of her EEGs have been normal. 

A head CT scan or MRI can also be ran, but that is usually to measure for any abnormal growths or brain abnormalities. 

Once there is a diagnosis of epilepsy, you start the process of trying to find a medicine to treat the seizures. This could take awhile because every brain is different.  The really positive thing is that there are many really good epilepsy medications available to treat seizures and maintain seizure control.  If medications fail, there is also the possibility of treating the seizures via the Ketogenic Diet.  Additionally, there are surgery options. 

There isn't a cure for epilepsy.  However, in some cases, a person can grow out of them, and after two years of having seizure control on medications, the doctor will usually begin the weening process to see if the patient can retain seizure control off of medications.  We've never reached that point.  We reach about 20 months of seizure control, and it never fails that my daughter has a seizure.  We start the count all over again.