Your doctor will ask for a detailed description of the seizure, which is crucial for diagnosis. Because people who have grand mal seizures lose consciousness and don't remember their seizures, the description needs to come from people who have witnessed the seizures.
Your doctor may try to determine whether a particular trigger, such as intense exercise, loud music, flashing lights (such as those caused by video games or television) or lack of sleep, preceded your seizure. However, most people have no identifiable or consistent trigger.
If you've had a seizure, your doctor usually will perform a neurological exam that tests:
- Muscle tone
- Muscle strength
- Sensory function
He or she may also ask questions to assess your thinking, judgment and memory.
Blood tests and scans
Blood tests may be ordered as appropriate to check for problems that could be causing or triggering the seizures.
Your doctor may also suggest scans or tests designed to detect abnormalities within the brain.
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Electroencephalogram (EEG). An EEG displays the electrical activity of your brain via electrodes affixed to your scalp. People with epilepsy often have changes in their normal pattern of brain waves, even when they're not having a seizure.
In some cases, your doctor may recommend video-EEG monitoring, which may require a hospital stay. This allows your doctor to compare — second by second — the behaviors observed during a seizure with your EEG pattern from exactly that same time.
This comparison can help your doctor pinpoint the type of seizure disorder you have, which helps identify the most appropriate treatment options, and it can help make sure that the diagnosis of seizures is correct.
Brain imaging. Computerized tomography (CT) scan and magnetic resonance imaging (MRI) produce detailed images of your brain and may reveal tumors, cysts and structural abnormalities.
During a CT scan or an MRI, you will lie on a padded table that slides into a machine. Your head will be immobilized in a brace, to improve precision while images of your brain are taken.
- Seizures and epilepsy: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm. Accessed March 11, 2014.
- Tonic-clonic seizures. Epilepsy Foundation. http://www.epilepsyfoundation.org/aboutepilepsy/seizures/genconvulsive/tonicseizures.cfm. Accessed March 11, 2014.
- Schachter SC. Evaluation of the first seizure in adults. http://www.uptodate.com/home. Accessed March 11, 2014.
- Seizure disorders. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/neurologic_disorders/seizure_disorders/seizure_disorders.html. Accessed March 11, 2014.
- Schmidt D, et al. Drug treatment of epilepsy in adults. British Medical Journal. 2014;348:g254.
- FDA Drug safety communication: Aseptic meningitis risk with use of seizure drug Lamictal. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm221847.htm. Accessed March 12, 2014.
- Ahmed R, et al. Epilepsy in pregnancy. Australian Family Physician. 2014;43:112.