Accurate diagnosis of a seizure disorder is critical in order to prescribe proper treatment, and obtain and maintain a healthy and productive lifestyle. Misdiagnosis can cause seizures to persist. The best way to diagnose epilepsy is through careful observation and documentation of symptoms, combined with a thorough medical examination, including evaluation of personal and family medical history, and appropriate neurological testing.

Careful observation and documentation of symptoms:
Chances are your physician may never see you actually have a seizure; although many people now have electronic devices that can videotape the person. An accurate description of what happens during the seizure is important. It can help your physician decide on treatment options.

The following guidelines can help you give an accurate description:

  1. Describe, as accurately as possible, what you observe in chronological order.
  2. Since the duration of the event is useful information for the physician, please time the seizure whenever possible.
  3. If possible, the person with epilepsy or a family member should maintain a seizure log with dates, time of day, any precipitating factors or triggers and descriptions of seizures. These descriptions can include the following information:
    1. Was there a cry and/or other sounds?
    2. Was there a staring episode in which the person did not respond or appeared to be daydreaming or preoccupied?
    3. Was there any twitching or jerking of any parts of the body?
    4. Was there any loss of bowel or bladder control?
    5. Did the person appear to be unconscious?
    6. Did you observe behavior such as lip smacking, humming, picking at clothes, rapid eye blinking, or wandering around in a confused manner?
    7. After the seizure, was the person confused, sleepy, or dazed?
    8. Did the person recall any sensory experience such as a bad odor, tingling, feeling of fear, etc.?

A thorough medical examination including evaluation of personal and family medical history:
An accurate personal history is very important, as well as family history. It is a good idea to check with older relatives about seizures in the family, as this information has sometimes been hidden in families.

Appropriate neurological testing:
The medical profession utilizes a variety of methods to diagnose epilepsy ranging from laboratory testing to imaging techniques.

  • Normally, an EEG (electroencephalogram) is conducted. An EEG records the electrical activity and patterns of the brain.
  • MRI (magnetic resonance imaging) may be performed. MRI images are pictures of the brain. They can reveal tumors, scarred tissue and structural changes.
  • In some cases inpatient hospital video/EEG monitoring at a comprehensive epilepsy center may be indicated.

Keep in mind that experiencing a seizure or an event that looks like a seizure does not necessarily mean that a person has epilepsy. Several conditions have been misdiagnosed as epilepsy including:

  • Febrile seizures, a seizure common among children that is induced by a high temperature
  • Breath-holding spells
  • Transient ischemic attacks (TIA), brief interruptions of blood flow to the brain
  • Psychiatric disorders: panic attacks, psychogenic seizures
  • Syncope
  • Tic