Diagnosis

The initial diagnosis of epilepsy is based upon an accurate description of the attacks. As patients are often unconscious or unaware during seizures, it is extremely important for the doctor to get an eyewitness description of attacks from another person. The doctor will need to differentiate seizures from other conditions such as fainting fits or heart problems. To help rule out non-neurological (not in the brain) medical causes of seizures, you doctor will order basic lab tests including blood chemistry and haematology (blood cells), urinalysis, and an electrocardiogram (ECG). Making a correct diagnosis can be difficult, and it is important for patients to see a specialist with sufficient expertise, such as a neurologist. If a diagnosis of epilepsy is made, the following tests are likely to take place:

• An electroencephalogram (EEG) This can help to work out what type of epilepsy the patient has, which in turn will guide the choice of treatment and prognosis.
• A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan may be given, especially if the patient is thought to have a focal epilepsy. These tests are used to look for brain abnormalities that may be causing the epilepsy.

It is important to note that you can suffer from epilepsy even if both the scan and the EEG are normal. If there is any uncertainty about the diagnosis, it may be helpful to have a prolonged EEG. This sometimes takes place over a number of days using video recording equipment to record any attacks.