Your doctor will take a detailed history from you as well as observers to help determine if you have epilepsy. The history will include questions about:

• Your past medical history
• Family medical history
• Any and all medications you take
• Seizure patterns:
  • How were you feeling before the seizure?
  • How old were you at the onset of the condition?
  • Was there any warning?
  • What did the seizure look like, or what were you told it looked like?
  • Were there any symptoms after the seizure?
  • How many seizures have you had previously?
  • After the seizure did paralysis, twitches, confusion, slowed responsiveness, urine incontinence, or tongue biting occur?

Your doctor will then perform a complete physical exam. Special attention will be given to your nervous system such as testing your reflexes and sensations. Tests will then be taken to see if you might have epilepsy, and if so, what type of seizures you have.

Placement of Sensors for an EEG

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Tests may include:

• Electroencephalogram (EEG) —This is a painless test, where wires are attached to your skull and measurements made of the electrical activity of your brain. An EEG is used to detect abnormal brain activity. Best results are achieved when this test is performed within 24 hours of a seizure. The EEG can be used to confirm epilepsy and help characterize the type. Many times repetitive or continuous EEG monitoring may be required.
• Magnetoencephalogram (MEG)—MEG monitors brain activity by measuring magnetic fields of the brain.
• Brain scans—These include the following:
  • CT scan and MRI scan —Both tests generate images of the brain’s structure, with the MRI usually showing greater detail. These scans are used to show tumors, cysts, or structural abnormalities in the brain.
  • PET scans —These scans monitor the brain’s activity and may show local abnormalities within the brain.
  • Single photon emission computed tomography (SPECT) scan—This scan is used to find the specific origin of seizure activity in the brain.
  • Magnetic resonance spectroscopy (MRS)—This is a relatively new procedure to find abnormalities in the brain’s biochemical processes.
• Blood tests—Blood tests check for possible causes of the seizures, including:
  • Metabolic disorders, such as abnormal blood levels of sugar, calcium, sodium, potassium, or magnesium
  • Genetic disorders
  • Infections, such as encephalitis, meningitis, or HIV
  • Lead poisoning
• Urine tests—These are sometimes necessary to rule out a drug overdose.
• Developmental, neurological, and behavioral tests—These tests measure of motor abilities, behavior, and intellectual capacity.
• Angiography —X-rays taken after injecting dye into the blood vessels leading into the brain. This test is done to detect abnormalities in the brain and the possibility of tumors.
• Echoencephalogram —This test is most often used in infants, using high-frequency sound waves to produce pictures of the brain and to detect abnormalities.
• Lumbar puncture (spinal tap) —This is the removal and examination of a small amount of fluid from the spinal cord. This test is sometimes done to determine if a seizure was caused by an infection, bleeding in the brain, or other less common causes.