Woman with a magnifying glassAccurate diagnosis of a seizure disorder is critical in order to 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, appropriate neurological testing and evaluation of personal and family medical history.

The medical profession utilizes a variety of methods to diagnose epilepsy ranging from laboratory testing to imaging techniques. Normally, EEG (electroencephalogram) monitoring is conducted to confirm suspicions of epilepsy. An EEG records the electrical activity and patterns of the brain. While an EEG is a common method of diagnosing epilepsy it can produce inaccurate results. For instance, if an EEG indicates an irregularity this does not mean that a person has epilepsy. Likewise, an EEG can also fail to identify epilepsy.

MRI (magnetic resonance imaging) and CT (computerized tomography) are used to evaluate the cause and location of epilepsy. Both MRI and CT scanned images can reveal tumors, scarred tissue and structural damage. If there is no reduction in seizure frequency despite treatment, inpatient hospital monitoring at a comprehensive epilepsy center may be indicated.

Keep in mind that experiencing 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

Chances are if you have a family member with epilepsy, your physician may never see that person actually have a seizure. But an accurate description of what happens during his or her seizure is important. It can help your physician decide if the anticonvulsant medication is helping or if changes are needed. The following guidelines can help you give an accurate description.

SEIZURE OBSERVATION GUIDELINES

1. Describe, as accurately as possible, what you observe in chronological order.

2. Since the duration of symptoms 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, and descriptions of seizures. These descriptions can include the following information:

  • Was there a cry and/or other sounds?
  • Was there a staring episode in which the person did not respond or appeared to be daydreaming or preoccupied?
  • Was there any twitching or jerking of any parts of the body?
  • Was there any loss of bowel or bladder control?
  • Did the person appear to be unconscious
  • Did you observe behavior such as lip smacking, humming, picking at clothes, rapid eye blinking, or wandering around in a confused manner?
  • After the seizure, was the person confused, sleepy, or dazed?
  • Did the person recall any sensory experience such as a bad odor, tingling, feeling of fear, etc.?