Epilepsy - Diagnosis

Highlights	Diagnosis	Surgery
Introduction	Treatment	Lifestyle Changes
Causes	Long-Term Treatment	Resources
Outlook and Effects	Medications	References

Diagnosis

An epilespy diagnosis is often made during an emergency visit for a seizure. If a person seeks medical help for a previous or suspected seizure, the doctor will ask about the patient's medical history, including seizure events.

One interesting study suggested that a doctor might be able to identify the location in the brain where the seizure is originating by watching the patient wipe his or her nose. A runny nose is common after a temporal lobe seizure, but not after seizures in other locations. Furthermore, the hand with which the patient wipes the nose coincides with the side of the brain in which the seizure occurs.

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Ruling Out Serious Causes & Similiar Conditions

Health- or life-threatening causes of seizures should first be ruled out. (See Causes in this report.)

The doctor will also rule out conditions that cause similiar symptoms, including:

Syncope. Syncope, a brief lapse of consciousness in which blood flow is reduced to the brain, can mimic epilepsy. It often misdiagnosed as epilepsy. Research continues to suggest that taking the patient's history and giving a physical exam, rather than administering an assortment of cardiac tests, is the most effective way to diagnose syncope.
Migraines. Migraine headaches, particularly migraine with auras, may sometimes be confused with epilepsy. With epileptic seizure, the preceding aura is often seen as multiple, brightly colored, circular spots, while migraine sufferers tend to see black, white, or colorless lined or zigzag flickering patterns. Typically the migraine pain expands gradually over minutes toward one side.
Panic Attacks. One study found that, in some patients, partial seizures resembled a panic disorder. Symptoms of panic disorder include palpitations, sweating, trembling, sensation of breathlessness, chest pain, feeling of choking, nausea, faintness, chills or flushes, fear of losing control, and fear of dying.
Narcolepsy. Narcolepsy, a sleep disorder that causes a sudden loss of muscle tone and excessive daytime sleepiness, can be confused with epilepsy.

Diagnostic Tools

Electroencephalogram (EEG). The most important diagnostic tool for epilepsy is an EEG, which measures brain waves. Ideally, it should be performed within 24 hours of a seizure. An EEG recording session may last for less than an hour, but in some cases the doctor will want a day-long recording. Long-term monitoring may be necessary in some cases when patients do not respond to medications. Portable EEG units are available in some places, which can be used to monitor patients throughout normal activities. EEGs are not foolproof; in one study half of people who had experienced an epileptic seizure showed a normal EEG reading. Repeated EEGs are often needed to confirm a diagnosis, particularly for certain partial seizures that often produce an initially normal EEG reading.